emedinews
Head Office: E–219, Greater Kailash, Part 1, New Delhi–110 048, India. e–mail: emedinews@gmail.com, Website: www.ijcpgroup.com
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 & Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; National Vice President Elect Elect, Indian Medical Association; Hony Director IMA AKN Sinha Institute (08–09); Hony Finance Secretary National IMA (07–08); Chairman IMA Academy of Medical Specialties (06–07); President Delhi Medical Association (05–06), President IMA New Delhi Branch (94–95, 02–04); Editor in Chief IJCP Group & Hony. Visiting Professor (Clinical Research) DIPSAR

For updates follow at www.twitter.com/DrKKAggarwal     www.facebook.com/Dr KKAggarwal

    Health Videos …
Nobility of medical profession Video 1 to 9 Health and Religion Video 1 to 7
DD Take Care Holistically Video 1 to 9 Chat with Dr KK On life Style Disorders
Health Update Video 1 to 15 Science and Spirituality
Obesity to Towards all Pathy Consensus ALLOVEDA: A Dialogue with Dr KK Aggarwal
  Editorial …

3rd December 2012, Monday

85 drugs can interact with Grapefruit (Chakotra)

There are now more than 85 drugs that may interact with grapefruit. The list includes statins (atorvastatin, lovastatin, and simvastatin), some antibiotics, cancer drugs, and heart drugs. Most at risk are older people who use more prescriptions and buy more grapefruit.

Grapefruit contains furanocoumarins, which block an enzyme that normally breaks down certain medications in the body. When it is left unchecked, medication levels can grow toxic in the body.

Other citrus fruits such as Seville oranges (often used in marmalade), limes, and pomelos also contain the active ingredients (furanocoumarins), but have not been as widely studied.

The findings appear in the Canadian Medical Association Journal.

This interaction can occur even if grapefruit is eaten many hours before taking the medication. For example, simvastatin, when taken with about a 7-ounce glass of grapefruit juice once a day for three days, produced a 330% greater concentration of the drug compared to taking it with water. This can cause life-threatening muscle damage.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

    Constipation Update

A normal imaging study should lead to evaluation of colonic transit and pelvic floor dysfunction.

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Intensive medical treatment prevents second stroke not intra cranial stenting

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

Mr Safdar Khan Chairman Minority Commission Govt of Delhi Learns hands only CPR 10

 
Dr K K Aggarwal
    National News

Dear Colleague, Let’s celebrate New Year by learning CPR-10 and saving the life of a person

Watch English or Hindi Video @http://emedinews.in/videos/cpr/index.html

Dr K K Aggarwal

Vaccine against dengue being developed: Ghulam Nabi Azad

NEW DELHI: A vaccine is being developed against dengue, government announced today hoping that its trials would be successful to enable containment of the deadly disease which is spreading and has claimed 216 lives so far this year. Health Minister Ghulam Nabi Azad told the Lok Sabha that the trials of the vaccine are at an advanced stage in several countries, including in India, and hoped these would pass. "The phase III of the trial is underway in the Philippines, Vietnam, Malaysia, Indonesia and Latin American countries....In India the trials are taking place in places like Ludhiana, Kolkata and Delhi. If it passes, the day is not far when we will get it," he said. Azad was responding to a call attention on the spread of dengue and the steps taken by the government in this regard, with members asking the government to take foreign help or even FDI to meet the "serious" situation. He hoped that the success of these trials by the French company, Sanofi Pasteur, come sooner than later so that deaths taking place due to dengue can be contained. The Minister said the spread of dengue infection has "shown an increase in recent years due to various man-made and environmental factors leading to proliferation of Aedes mosquito breeding sites, both in urban and rural areas." Observing that the dimension of the problem could be gauged by the number of cases reported and deaths, he said up to November 15 this year, 35,066 cases, including 216 deaths, have been reported. However, the case fatality rate has remained low at 0.6 per cent. The total number of suspected Chikungunya cases has declined, with 14,227 reported till November 15. (Source: Indian Express, 30 Nov, 2012)

Medical mistakes in Indian movies

Dear all, eMedinewS is starting a special series on ‘Medical mistakes in Indian movies’. We invite all our readers to share with us the following information:

  1. Scene/s where the image of the medical profession has been maligned in an unrealistic manner, or
  2. Scene/s where medical care and approach has been depicted incorrectly, or
  3. Scenes where the medical profession has been portrayed correctly.

Send us the clippings or description of the scenes. This would be a start to a special campaign to rebuild the image of the medical profession.

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

 
    Valvular Heart Disease Update

Valvular thickening or sclerosis of the aortic and mitral valve is a frequent occurrence in hemodialysis patients and occur in 55 to 69 percent of individuals.

(Experts: Dr Ganesh K Mani, Dr Yugal Mishra, Dr Deepak Khurana, Dr Rajesh Kaushish, Dr K S Rathor, Dr Sandeep Singh and Dr KK Aggarwal)

For Comments and archives…

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

FDA panel turns thumbs down on Vibativ

An FDA panel voted 9-6 on Thursday against recommending approval of a new indication for hospital-acquired pneumonia for the skin infection drug telavancin (Vibativ). However, most panelists on the FDA's Anti-Infective Drugs Advisory Committee agreed telavancin should be approved, with the significant caveat that it only be used in nosocomial pneumonia patients with methicillin-resistant Staphylococcus aureus (MRSA) who have creatinine clearance above 30 mL/min, the committee chair said. (Source: Medpage Today)

Study dashes epicardial fat theory on MIs

An imaging study has dashed a hypothesis that fat around the heart might explain why African Americans have a higher heart attack rate than whites, researchers reported here at the annual meeting of the Radiological Society of North America. The average epicardial fat among 204 African Americans was 63.7 mL, compared with 105 mL of epicardial fat among 207 matched Caucasians (P<0.001), said Paul Apfaltrer, MD, radiology resident at the University Medical Center Mannheim at Heidelberg University in Germany. (Source: Medpage Today)

Magnet device aids in spinal cord injury

Precisely timed nerve stimulation in patients with spinal cord injuries improved their ability to use their hands, at least temporarily, researchers reported. (Source: Medpage Today)

Tdap vaccine shown safe in older patients

The tetanus-diphtheria-acellular pertussis (Tdap) vaccine appears to be as safe and effective as the tetanus and diphtheria vaccine in patients ages 65 and older, researchers found. (Source: Medpage Today)

Mammograms down after USPSTF recommendations

The U.S. Preventive Services Task Force (USPSTF) recommendation for a radical change in breast cancer screening appears to have sharply reversed a decade-long increase in screening mammography, researchers said at the annual meeting of the Radiological Society of North America. (Source: Medpage Today)

 
  Twitter of the Day

@DrKKAggarwal: I uploaded a @YouTube video http://youtu.be/9skyAt1J3FU?a Multi Rescuer Hands only CPR 10 1050 Get Training at Birla Vidya Niketan

@DrKKAggarwal: Is there any way to get over the fear that comes after losing a parent? http://tinyurl.com/bnc7cm6

 
    Spiritual Update

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

What is the Importance of Mehendi Ceremony in Marriage?

“It is said that the husband’s name in the intricate henna motifs is made for the bridegroom who has to find out his name in his bride’s mehendi as an evidence of his sharp eyes and active brain to impress his girl.”

For comments and archives

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

Are there any dietary supplements or vitamins that I can take to improve morphology?

Dietary supplements or vitamins have not been clearly shown to improve sperm morphology. Some specialists do recommend that you take a daily multivitamin to improve a number of body functions, including reproductive health.

 
    Tat Tvam Asi………and the Life Continues……

(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

False Negatives

Positive DAT - Rh HDN - blocking D antigen sites - elute and retype

 
    An Inspirational Story (Dr GM Singh)

Teen Mental Health

Being a teenager is hard. You're under stress to be liked, do well in school, get along with your family and make big decisions. You can't avoid most of these pressures, and worrying about them is normal. But feeling very sad, hopeless or worthless could be warning signs of a mental health problem.

Mental health problems are real, painful and sometimes severe. You might need help if you have the signs mentioned above, or if you

  • Often feel very angry or very worried
  • Feel grief for a long time after a loss or death
  • Think your mind is controlled or out of control
  • Use alcohol or drugs
  • Exercise, diet and/or binge-eat obsessively
  • Hurt other people or destroy property
  • Do reckless things that could harm you or others

Mental health problems can be treated. To find help, talk to your parents, school counselor or health care provider.

For comments and archives

 
  Cardiology eMedinewS

3d Echo Tracks Heart Damage From Chemo Read More

Promising New Way To Make Stem Cells Aid in Fight Against Heart Disease Read More

 
  Pediatric eMedinewS

Undescended testes may raise cancer risk Read More

Baby's obesity risk? Look at the family Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A 36–year–old executive used to take 5 pegs of alcohol once a week.
Dr Bad: Continue it.
Dr Good: Take only one peg a day or stop it.
Lesson: The French habit of drinking wine almost daily is less taxing to the heart than the Irish custom of downing an equivalent amount of beer on one or two nights a week, according to a study published Nov. 23 in the British Medical Journal.

Make Sure

Situation: A 40–year–old hypertensive complains of head reeling in spite of being on antihypertensive.
Reaction: Oh my God! Her blood pressure is still high. Why didn’t you advise lifestyle modification?
Lesson: Make sure to first advise lifestyle modifications like exercise, low salt diet, high fiber diet, decreasing stress etc. before advising antihypertensive medication, in essential hypertensives.

 
  Quote of the Day (Dr GM Singh)

Do not spoil what you have by desiring what you have not; remember that what you now have was once among the things you only hoped for.

 
    Legal Question of the Day (Dr MC Gupta)

Q. What are your comments about the recent consumer court judgment in Delhi awarding Rs. 10 lakh as compensation for medical negligence during gall-bladder surgery in 2008, leading to death?

Ans.

  1. You are obviously referring to the following news item dated 29 November 2012

    -- http://www.financialexpress.com/news/pay-compensation-rs-10l-for-patients-death-consumer-forum-to-doctors-nursing-home/1038017

    The summary of the news, titled as: “Pay compensation Rs 10L for patient's death: Consumer forum to doctors, nursing home”, -- is as follows:
    1. Two doctors, a local nursing home and its owner have been ordered by a consumer forum here to pay Rs 10 lakh as compensation to the widow and minor children of a person for medical negligence in his surgery for removal of gall-bladder in 2008, leading to his death.
    2. The South West District Consumer Disputes Redressal Forum held Shakuntala Nursing Home of Sagarpur, its owner J Raj Dhami and Dr Bhupendra Pal Dhami and Dr Vikas Gupta (surgeon) guilty of medical negligence on basis of a Delhi Medical Council (DMC) report.
    3. Referring to the report, a bench headed by Narendra Kumar said "the case is a perfect example of malaise which plagues numerous nursing homes run by such unscrupulous persons like J Raj Dhami who project themselves as doctors and lure gullible citizens into their trap and qualified doctors like Dr Gupta, by associating themselves with such individuals, promote such nefarious activities."
    4. The DMC had said there was deficiency in post operative care of the patient and had directed removal of Dr Gupta's name from the state medical register for 30 days, ordered a probe and stringent action against the nursing home and prosecution of J Raj Dhami on the ground that he was not a qualified doctor.
    5. "In light of the observation of DMC, it is clear opposite parties 1 (nursing home), 2 (Raj Dhami), 3 (Dr Bhupendra) and 4 (Dr Gupta) are guilty of medical negligence and liable for payment of compensation to complainants. "We direct them to pay Rs 10 lakh jointly or severally to the complainants (widow and children of deceased). They are also directed to pay jointly and severally a sum of Rs 20,000 towards cost of litigation," the forum said.”
  2. The guilty nursing home was owned by a non-allopathic person who managed it with the help of allopathic family members and other RMPs.
  3. There was clear negligence. The 42 years old man died in Ganga Ram Hospital where treatment was later given.
  4. The widow filed three complaints-- To: Medical Council; Consumer court; Police. The first two have been decided against the defendants. The third one is bound to be decided likewise.
  5. “Cross pathy”, which is common among medical practitioners qualified in AYUSH streams and registered with the respective councils, is an outright crime. The law has been clearly laid down in Poonam Verma Vs. Ashwin Patel and Others, decided by the Supreme Court on 10.05.1996, as follows: “41. A person who does not have knowledge of a particular System of Medicine but practices in that System is a quack and a mere pretender to medical knowledge or skill, or to put it differently, a charlatan.”
  6. The law against nursing homes employing non-allopathic “doctors” has been laid down by the National Commission in Prof. P.N. Thakur v. Hans Charitable Hospital, NC, 16 Aug. 2007, where the Commission made the following observation— “As regards the fixing of the liability for the above gross negligence that has taken place, we have to hold Respondent No.1, the Hospital as mainly responsible. They have employed an unqualified Doctor to administer and provide allopathic treatment to the patient. As stated above, since Dr. Rehan did not even produce his Registration Certificate with Delhi Chikitsa Board, a doubt is left in our mind as to whether he is qualified even as Unani Doctor. Employing such unqualified person and further allowing him to treat complicated and emergency cases is a gross negligence on the part of the Hospital.” The full judgment can be viewed at— http://ncdrc.nic.in/OP21497.HTML
  7. The reason why allopathic practitioners do not take action against quackery in the form of AYUSH practitioners practicing allopathy is clearly illustrated by this case. The father was a non-allopath practicing allopathy in a clinic owned by him where allopath son and other allopaths worked for gain. This is nothing short of illegal conspiracy to cheat and harm the public illegally.
  8. I wish the Clinical Establishments Act, 2010, which has already been notified, is actually put to use on ground without further delay. That is the only way to curb the menace of hospitals and nursing homes fooling the public by presenting non-RMPs as RMPs by the simple device of donning them with a white coat and a stethoscope.
  9. The above statement is correct in spite of my strong resentment against the CEA, 2010, against which I am going to file, for my client, a WP, already drafted, within a week. My main grouse is regarding section 12(2) which imposes a statutory duty upon the hospital/doctor to provide treatment without any mechanism for compensation for the same.
  10. An issue in this case was also that—“whether the insurance company is a necessary party where doctors have insured themselves by purchasing a professional indemnity insurance policy?”

    In this case, the District Forum (DF) had passed an order dismissing the application by a defendant doctor to implead the insurance company that issued a professional indemnity policy. He appealed to the State Commission against the order. On 15-10-2008, the State Commission, Delhi, decided Appeal no. FA-2008/924 titled as Dr. Mohit Garg v. Mrs. Manju Gupta & Ors. in favour of the applicant and observed that:

    "Insurance company is a necessary party firstly for the reason that doctors of the hospital insured themselves for the medical peril and secondly for the reason to avoid multiplicity of litigation. This view has been confirmed by various decisions of the National Commission as well as the Supreme Court".
  11. One of the NC judgments referred above by the State Commission is “Dr. C.C. Choubal vs Pankaj Srivastava on 29 May, 2003”. It can be viewed at--

    http://www.indiankanoon.org/doc/525652/

    The NC observed in this judgment as follows:

    “In a case of medical negligence against the petitioner-doctor, an application was filed by him to implead the Insurance Company as correspondent. This application was dismissed by the District Forum and appeal against that by petitioner was also dismissed by State Commission. Insurance Company may not be a necessary party but it is certainly a proper party inasmuch as claim against the Doctor would be covered if there is any medical negligence found against him. It would be more appropriate if Insurance Company is made a co-respondent. Subsequently the orders against the Doctor, if any, are passed there would be no difficulty for the complainant to get the amount of compensation to the extent of amount of the policy from the Insurance Company. In this view of the matter we do not feel necessary to issue notice to respondent-complainant and we allow this petition. Orders of District Forum and State Commission are set aside and application of the doctor is allowed. Insurance Company shall be impleaded as a co-respondent.”
 
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    Mind Teaser

Read this…………………

Which of the following represents a significant risk immediately after surgery for repair of aortic aneurysm?

a. Potential wound infection
b. Potential ineffective coping
c. Potential electrolyte balance
d. Potential alteration in renal perfusion

Yesterday’s Mind Teaser: A client is admitted to the hospital with benign prostatic hyperplasia, the nurse most relevant assessment would be:

a. Flank pain radiating in the groin
b. Distention of the lower abdomen
c. Perineal edema
d. Urethral discharge

Answer for Yesterday’s  Mind Teaser: B. This indicates that the bladder is distended with urine, therefore palpable

Correct answers received from: MANOJ ARON, Dr. P. C. Das, Dr.R.K.Goel, Dr.K.Raju, Dr Jainendra Upadhyay, Dr Pankaj Agarwal, Muthumperumal Thirumalpillai, Dr Chandresh Jardosh, Dr.(Maj. Gen.) Anil Bairaria, Dr. Thakor Hitendrsinh G, Dr Vijay Kansal, Alok Narang, Dr Avtar Krishan, Dr B K Agarwal, Dr Kanta jain, Dr Kanta jain

Answer for 1st December Mind Teaser: D) Client’s perception of the change

Correct answers received from: Dr.Suresh Arora, Dr.K.Raju, Archna Parwani

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

"As you get older three things happen. The first is your memory goes, and I can't remember the other two... " Sir Norman Wisdom

 
    Medicolegal Update

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

Hair and fiber in forensic cases

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

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Avoid drunk or drugged driving

The dangers of drinking alcohol and driving are well known to all. But, it is also important to recognize that taking drugs and driving too can be as dangerous, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India. Drugged driving or driving under the influence of any drug that acts on the brain can adversely affect your, vision, reaction time and judgment and driving skills. This not only endangers your life but also of your co-passengers as well as others on the road.

Tips for safe driving

  • All through the year, especially during the holiday season, take steps to make sure that you and everyone you celebrate with avoids driving under the influence of alcohol or other drugs.
  • Always designate a non-drinking driver before any holiday party or celebration begins.
  • Arrange for someone to pick you up
  • Do not let a friend drive if you think that they are impaired. Take the car keys.
  • Stay overnight at your friend’s place, if possible and drive back home in the morning.
 
    Readers Response
  1. Dear Sir, Thanks for updating our information. Regards: Dr SP Yadav
 
    Forthcoming Events

4th eMedinews Revisiting 2012

(a day long single hall medical conference on 2012 happenings, followed by doctors of the year 2012 awards)

Sunday 20th January 2013, Maulana Azad Medical College Auditorium

Dilli Gate Delhi

8am-8pm

Dr KK Aggarwal
Padmashri and Dr B C ROY National Awardee President

Dr Veena Aggarwal
Executive Editor IJCP Group
Organizing Chairman

Dr Pawan Gupta
Past President IMA Haryana
Organizing Secretary

4th eMedinewS Revisiting 2012

The 4th eMedinewS–revisiting 2012 conference is being held at Maulana Azad Medical College, New Delhi on Sunday January 20th 2013.

The one–day conference will revisit and discuss all the major advances in medicine in the year 2012. There will also be a live webcast of the event. An eminent faculty will speak at the conference.

There is no registration fee. All delegates will get Registration Kit, Attractive gifts, Certificates. Morning snacks and lunch will be provided.

Register at: www.emedinews.in/

rawat.vandana89@gmail.com/drpawangupta2006@yahoo.com

4th eMedinewS Doctor of the Year Awards

Nominations invited for 4th eMedinewS Doctor of the year Award in plain paper. Nominated by 2 professional colleagues along with details of your contributions in the year 2012.

pls send his/her Biodata at: emedinews@gmail.com

 
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    Our Contributors

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta, Dr Usha K Baveja