December 3   2015, Thursday
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Dr KK AggarwalDr KK Aggarwal Even in US over 83% pregnant woe receive one drug or the other

Everyone is concerned about using drugs during pregnancy, especially for drugs that may have adverse outcomes for the mother or her foetus.

In a study of over one million pregnant women in the United States Medicaid program, nearly 40 percent were prescribed a potentially harmful medication (category D, most commonly codeine and hydrocodone) and 5 percent were prescribed a medication contraindicated during pregnancy (category X, most commonly hormonal contraceptives that were prescribed prior to the diagnosis of pregnancy).
Over 83% were dispensed at least one medication of any kind (most commonly antibiotic or antifungal agents).

In pregnancy the lowest risk option is to avoid drug exposure if possible. [Obstet Gynecol 2015; 126:465., uptodate]
Amit Sharma and Nilesh Aggarwal

We are extremely happy to have been part of IMA Satyagraha campaign and would like to congratulate the Indian doctor community as a whole. We are aiming to be a digital voice of all Indian doctors and will continue to work towards raising such important issues. Currently, we are in our Beta phase and we will soon be introducing features such as interesting cases, online CME's, conference updates etc. Please do register and read eMediNews, eIMANews as well as other engaging content on the website/app. You can also add other doctors to your network, find long lost alumni, chat and discuss cases, post questions for the medical fraternity, create your detailed medical resume and lots more.
Breaking News
India continues to remain free of wild poliovirus

A vaccine-derived poliovirus (iVDPV) was reported from an immunodeficient child in the national capital region recently. The occurrence of an iVDPV is an extremely rare phenomenon and only about 100 cases with immunodeficiency have been documented to be excreting iVDPVs globally since 1961. India continues to remain free of wild poliovirus. The occurrence of this case should not be confused with the wild poliovirus that was responsible for paralysis of thousands of children each year until it was eradicated from India in 2011.An iVDPV can occur in a person with a rare immunodeficient disorder because the body does not initiate an immune response to the vaccine as a healthy child would. Ongoing poliovirus surveillance, including environmental surveillance, through sewage sample testing in the area has not revealed any poliovirus circulation in the area. In line with the global guidelines of WHO for response to VDPVs to mitigate the risk of spread of the VDPV, the Ministry of Health and Family Welfare conducted a polio round from 6th November,2015 to immunize all children under 5 years, in the vicinity of the area where the case was detected... (PIB)

Govt changes criteria to make more HIV patients eligible for ART

As HIV/AIDS spread to new states that were not at risk from the disease in the past, the Union Health Ministry has tweaked its policy to provide free drugs to more HIV positive patients. Almost 47% of new HIV infections in 2015 occurred in Andhra Pradesh, Telangana, Bihar, Gujarat and Uttar Pradesh. Of these, the only known high-risk states were Andhra Pradesh, Telangana included. Assam, Chhattisgarh, Gujarat, Tripura and Uttar Pradesh are reporting a rise in new infections. Andhra Pradesh, Bihar, Maharashtra and West Bengal account for 47% of the total AIDS-related deaths. Gujarat, Karnataka, Odisha, Rajasthan, Tamil Nadu and Uttar Pradesh report high death rate due to HIV. The Health Ministry changed the eligibility criteria to bring in more patients under the umbrella. “The cut-off level for initiation of antiretroviral therapy (ART) will henceforth be a CD4 count of 500. With this decision an additional 1 lakh persons will start receiving the benefits of treatment. It has also been decided to offer the third line of treatment to patients who need it. National AIDS Control Organisation has been asked to gear up for these initiatives and we hope to start the actual delivery in the coming weeks.” said Health Minister J P Nadda. (Deccan Herald - Kalyan Ray)
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Specialty Updates
• The detection of breast cancer is better with digital breast tomosynthesis, which creates a 3-dimensional picture using X-rays, than with standard mammography, suggest the results from a 3-year study presented at the Radiological Society of North America 2015 Annual Meeting.

• The levels of virus in the blood (viremia) for patients with Ebola virus disease (EVD) are strong predictors of fatality, suggested a study published in PLos Medicine.

• According to an analysis published in the December 1 issue of the Journal of the American College of Cardiology, bioprosthetic valve thrombosis (BPVT) is more common than often perceived and develops long before the valve fails structurally in patients with symptoms referred for surgery. The report also identified independent clinical and echocardiographic predictors of thrombosis in such valves that included paroxysmal atrial fibrillation (AF), subtherapeutic anticoagulation and abnormal cusp motion.

• According to a new research published in JAMA, for optimum safety, 19% of births should be by cesarean section. Researchers noted that as the percentage of C-sections increases up to 19%, maternal and neonatal mortality rates decline.

• Patients receiving the aromatase inhibitor anastrozole had a higher incidence of carpal tunnel syndrome compared with controls, revealed an exploratory analysis of participants in the International Breast Cancer Intervention Study II (IBIS-II), published online in the Journal of Clinical Oncology.

• Gastric artery embolization shows promise for helping morbidly obese patients lose weight, suggested preliminary results of a study presented at the annual meeting of the Radiological Society of North America (RSNA).

• Researchers at the Oral Health Cooperative Research Centre (CRC), based at the University of Melbourne, Australia, tested different types of sugar-free drinks, including soft drinks and sports drinks, and found that those containing acidic additives and those with low pH levels cause measurable damage to tooth enamel, even if they have no sugar.

• The European Commission has approved glycerol phenylbutyrate as adjunctive therapy for adults and children aged 2 months or older with urea cycle disorder who cannot be managed by dietary protein restriction and/or amino acid supplementation alone.
The vast power of the Spirit

Om Poornamadah, “Om Poornamadah Poornamidam, Poornaat Poornamudachyate
Poornasya Poornamaadaaya, Poornameva Avasihyate”

The whole is whole; if you take away the whole away from the whole the whole will still remain. (That is infinite, this is infinite, from the infinite, the infinite has come out. Having taken the infinite out of the infinite, the infinite alone remains).

(In Vedanta “That” represents super consciousness, God or the Brahman and “This” the visible universe)

Atman, which makes up our body, is 99.99% space and if we look at the rest, it is also nothing but space or void. This void or ‘akasha’ is what is called Brahman, God or consciousness and is a web of energized information. This web of information of inner space called inner consciousness is the Atman or the Soul. This is connected with the outer space in the universe having a similar web of energized information called the Spirit or Brahmand.

This spirit has been given many names by different religions. Allah (Islam), Buddha (Buddhism), Brahman (Hinduism), Christ (Christianity) or Wahe Guru (Sikhism), all signify the same. This spirit, the energized field of information, is a powerful expression of live energy which can move faster than the speed of light. Soul is nothing but an individualized expression of the spirit.

This energy containing information in the spirit cannot be seen, felt, touched, tasted or smelt. It is beyond the perception of five senses. One cannot destroy it with a weapon, fire, water or air. This consciousness is embedded in the space of each and every cell of the body. It is like sugar added to the milk. Once added, you cannot find it as it gets embedded with each and every drop of the milk.

Soul originates from the spirit. Each soul differs from the other by way of the subtle layer of consciousness called the ‘sukshma sharira’ which is controlled by the triad of actions, memories and desires. Spirit is like light, which is always positive and only removes darkness. The basic nature of the consciousness is “truth and bliss”. The soul and the spirit are devoid of hatred, anger or jealousy and are full of unconditional love. They are nothing but a treasury of information about everything. This infinite information is capable of doing anything, including miracles. It is like the flame of a candle, which can light an infinite number of candles, while still retaining its illumination to the same degree.

Dr Deepak Chopra once said that the soul is like the voice of Lata Mangeshkar coming out of a radio, and even if you break the radio, you will not find Lata Mangeshkar in it. Similarly, even if you cut the body into pieces, you cannot find the physical presence of the spirit.

Spirit is present all over, be it the universe or the living beings. Any amount of spirit taken out from it will not make any difference to the spirit. In religious terms, the infinite or the vastness is equated and described by the blue color, and that is one reason why most of the gods are represented by the blue color, or are shown in the background of blue sky. This only represents the vastness and infinite character of the consciousness. One of the Gurus explained to his disciple the description of the spirit by the following equation. 1×1=1, 1/1=1 or, in other words everything is one. One can also explain it by the equation that infinity when added, subtracted, multiplied or divided by infinity will result in infinity only.

This infinite potential in our mind is present in between the thoughts and can be experienced by enabling oneself to go in between the thoughts by a process called mediation. One can experience the silent gap between the thoughts either with the use of primordial sound mantra as a vehicle or by way of yoga. People who have learnt meditation and have achieved the ability to go into the silent gaps can accomplish everything in their life using the principles of intention and attention. After any intention is introduced in the silent gap, a new reality can be created.

“That which is born of the flash is a flash; that which is born of the spirit is spirit” (John)
Legal Quote
V. Kishan Rao vs Nikhil Super Speciality Hospital on 8 March, 2010 Civil Appeal No. 2641 / 2010

“… before the consumer Fora if any of the parties wants to adduce expert evidence, the members of the Fora by applying their mind to the facts and circumstances of the case and the materials on record can allow the parties to adduce such evidence if it is appropriate to do so in the facts of the case.”
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IMA National Health Scheme

Constitution Rules & Byelaws
Approved by the 75th Central Council Meeting on 27th December 2014 at Ahmedabad, Gujarat

1. Title:-
The Scheme shall be known as “IMA National Health Scheme” (IMA NHS)

2. Registration: It shall function as an activity of National IMA and managed by IMA National Health Scheme as per rules & Byelaws of the Scheme. IMA National Health Scheme was passed in the central council by a resolution dated 28th December 2012 at Kanyakumari. The constitution Rules and Byelaws approved by the 75th Central Council Meeting on 27th December 2014 at Ahmadabad ,in Gujarat and Launched the scheme in January 2015 with its office at Thiruvananthapuram

3. Aims and Objectives of the Scheme
To provide financial assistance to the members and his/her spouse, child (ren) and parent(s) on the event of hospitalization, diagnosis and management of the following diseases:-

(a) Heart Disease: - Angioplasty, By-pass Surgery and Valve replacement Surgery.
(b) Renal Failure, Haemodialysis, Renal Transplantation,
(c) All Malignant diseases
(d) Brain Tumors
(e) Hip and Knee replacement surgery.
(f) Spine and disc surgery
(g) Cerebrovascular accidents
(h) Road Traffic and other accidents
(i) Other major illness requiring hospitalization approved by the scrutinizing committee appointed by the IMA National President

4. Beneficiaries

a) Benefits of the scheme shall be available only to the member and his / her spouse, child (ren) and parent(s), if the member has paid the membership subscription of his and his/ her spouse child (ren) and Parent(s).

b) In the event of death of a member, the spouse, child (ren) and parents can opt as a beneficiary member of the scheme.

c) Such a beneficiary member shall not have any other right including the right to contest or to vote.

5. Eligibility for Membership:-

(a) Life member of IMA.
(b). Member should be below the age of 80 years at the time of joining.

6. Admission Fee. (A F) For members / Spouse / Parents

(a) Below age of 35 yrs                                                       Rs. 1000.00
(b) Below age of 45 Yrs but above 35 Yrs                           Rs. 1250.00
(c) Below age of 55 Yrs but above 45 Yrs                           Rs. 1750.00
(d) Below age of 60 Yrs but above 55Yrs                            Rs. 5000.00
(e) Below age of 65 Yrs but above 60 Yrs                           Rs. 7000.00
(f) Below age of 70 Yrs but above 65 Yrs                            Rs. 8000.00
(g) Below age of 80 Yrs but above 70Yrs                            Rs.10,000.00

For child (ren) of members
Child (ren) below the age of 25 Yrs                                    Rs. 1000 .00

7. Annual Membership Subscription (AMS)

Every member/ beneficiary member Rs 500.00
Out of Rs 500/- annual membership fee Rs 300/- will go to National IMA account and Rs 200 to Scheme.

8. Annual Financial Assistance Contribution (AFAC)

Every Member / beneficiary member / Child (ren) shall pay the following amount.

i. Children below 25 yrs                                    Rs. 2500.00
ii. Below the age of 55 yrs                                Rs. 3000.00
iii. Above 55 and below 60 yrs                          Rs. 5000.00
iv. Above 60 and below 65 yrs                          Rs. 7000.00
v. Above 65 and below 70 yrs                           Rs. 8000.00
vi. Above 70 and below 80 yrs                          Rs. 10000.00

When a member / Spouse / Child(ren) / Parents first join the scheme they should pay the Admission fee, Annual membership subscription and Advance financial assistance contribution (AF + AMS + AFAC) at the rate mentioned above. Prescribed application form along with the admission fee, Annual membership subscription and Advance Financial Assistance Contribution drawn in favour of the scheme “IMA National Health Scheme” by A/C Payee draft payable at the secretary’s office has to be sending to the Hony. Secretary’s office. No cash or money order will be accepted. Admission fee (AF) is onetime payment, Annual membership subscription and advance financial assistance contribution shall be paid every year (AMS +AFAC).

Founder Member

Members who join first time will get the status of founder member Irrespective of age group. There will be a concession of Rs 1500 to those who join above the age of 55 years since they are paying higher premium. This benefit will be only for six months only from March 1st to 30th September 2015. This benefit is to give opportunity for all below 80 years. After September this benefit will stop and have to pay as the prescribed tariff above… (To be contd.)
Retirement Tax Suggestions

All investments can produce income to supplement retirement. However, one must retain some liquidity and keep a portion of the funds invested to offset inflation.

(Source: IJCP)
22nd MTNL Perfect Health Mela, the annual flagship event of the Heart Care Foundation of India

Viruses associated with pharyngitis in adults include influenza, parainfluenza, coronavirus, rhinovirus, adenovirus, enterovirus, respiratory syncytial virus, metapneumovirus, herpes simplex virus (HSV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and the human immunodeficiency virus (HIV). Co-infections with streptococci and viruses may occur
India success story of a strong response to HIV/AIDS continues

Millennium Development Goal of halting and reversing the epidemic achieved

New HIV infections declined by 66% while AIDS-related deaths by 54% between 2007 and 2015

4.5 lakh AIDS related deaths averted

The 2015 HIV estimates reaffirm the sustained declining trend in HIV prevalence and in new HIV infections at the national level in India. While HIV prevalence has overall declined from 0.37% in 2000 through 0.34% in 2007 and now to 0.26% in 2015, new infections in the same period have decreased by 66% to 86,000 in 2015. Rapid scale up of Antiretroviral Therapy (ART) has a very significant impact in producing a drop in AIDS-related deaths by 54% from 2007 to 2015… (PIB)
UN marks World AIDS Day with ‘new hope’ as momentum builds to break epidemic by 2030

The first World AIDS Day since political leaders The first World AIDS Day since political leaders committed to ending the epidemic by 2030 as part of the United Nations-led Sustainable Development Goals (SDGs) has generated “new hope” to break the epidemic and keep it from rebounding in “an unparalleled opportunity to change the course of history forever.” “This year, we mark World AIDS Day with new hope,” Secretary-General Ban Ki-moon said in his message on the Day, which is celebrated on 1 December each year as one of the most recognized international ‘health days’ and a key opportunity to raise awareness, commemorate those who have passed on, and celebrate victories, such as increased access to treatment and prevention services. He further said, “We have a lot to learn from the AIDS response. One by one, people stood up for science, human rights and the empowerment of all those living with HIV. And this is how we will end the epidemic: by moving forward together.” … (UN News Centre)
17 countries in Americas may have eliminated mother-to-child transmission of HIV

Data from 17 countries and territories across the Americas, including the United States, Canada and Chile, show they may have eliminated mother-to-child transmission of HIV and syphilis, the UN World Health Organization said on Monday. The countries were able to cut mother-to-child transmission of HIV by improving pregnant women's access to prenatal care, HIV testing and antiretroviral treatment, said the WHO and its regional arm in the Americas, the Pan American Health Organisation (PAHO). The 17 countries and territories, including several Caribbean islands, report "data consistent with dual elimination" of HIV and syphilis, with births in those places accounting for about a third of all births in the region, PAHO/WHO said. PAHO/WHO considers a country to have eliminated mother-to-child transmission of the two diseases after a validation process that examines whether these goals have actually been met. In June, Cuba became the first country in the world to receive WHO validation that it had eliminated the transmission of HIV and syphilis from mothers to children… (NDTV)
Patients with type 2 diabetes may benefit from increased potassium intake

The higher the levels of urinary potassium excretion, the lower the risk for renal dysfunction and cardiovascular complications in patients with type 2 diabetes and normal renal function at baseline suggesting that increased potassium intake could be of benefit in such patients (Clinical Journal of the American Society of Nephrology). According to Shin-ichi Araki, MD, PhD, from Shiga University of Medical Science, Japan said that reduced-calorie and low-sodium diets are commonly recommended for patients with type 2 diabetes, but such diets may be lacking in potassium… (Medscape)
Tinel’s sign

Tinel's sign is a way to detect irritated nerves. It is performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling or "pins and needles" in the distribution of the nerve. It takes its name from French neurologist Jules Tinel (1879-1952). For example, in carpal tunnel syndrome where the median nerve is compressed at the wrist, Tinel's sign is often "positive" causing tingling in the thumb, index, middle finger and the radial half of the fourth digit. Tinel's sign is sometimes referred to as "distal tingling on percussion" or DTP. This distal sign of regeneration can be expected during different stage of somatosensory recovery. Although most frequently associated with carpal tunnel syndrome, Tinel's sign is a generalized term, and can also be positive in ulnar nerve impingement at the wrist (Guyon's canal syndrome), where it affects the other (ulnar) half of the fourth digit and the fifth digit.
Blood pressure drugs should be taken at night

Uncontrolled blood pressure can lead to heart attacks, paralysis and heart failure. Most such attacks occur in the early morning hours. Pulse, blood pressure and thickening of platelets are all higher in the early morning hours.

Controlling early morning blood pressure can reduce cardiovascular mortality. According to a study published in the Journal of the American Society of Nephrology, among patients with chronic kidney disease and high blood pressure, taking at least one antihypertensive drug at bedtime significantly improves blood pressure control, with an associated decrease in risk for cardiovascular events.

The study included 661 patients with chronic kidney disease who were randomly assigned either to take all prescribed anti BP drugs on awakening or to take at least one of them at bedtime. Patients were followed for a median of 5.4 years; during that time, patients who took at least 1 BP–lowering drug at bedtime had approximately one third of the cardiac risk compared with those who took all medications on awakening. A similar significant reduction in cardiac deaths, heart attacks and paralysis was noted with bedtime dosing. Patients taking their medications at bedtime also had a significantly lower mean BP while sleeping. For each 5 mmHg decrease in mean sleep–time systolic upper BP, there was a 14% reduction in the risk for cardiovascular events during follow–up. Potential explanation for the benefit of night time treatment may be associated with the effect of night time treatment on urinary albumin excretion levels. Urinary albumin excretion is significantly reduced after bedtime, but not morning, treatment.
WP(C) No.8706/2015 titled “Indian Medical Association Vs. Union of India & Anr (NCERT)” Delhi High Court, New Delhi

Click here to read the proposed changes
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Bioethical issues in medical practice
Duty as a parent

Smita N Deshpande
Head, Dept. of Psychiatry, De-addiction Services
PGIMER-Dr. Ram Manohar Lohia Hospital
Park Street, New Delhi

Rina is mother to Chini, an 11 year old girl with mental retardation. Chini can barely look after herself. Her mother is constantly worried as to how she will look after herself when her periods start. At present Chini has barely learnt to bather herself, speak intelligible sentences and move around by herself. However Chini has no idea about her own disability and loves watching romantic scenes on TV. Rina is worried that in these insecure times, Chini may end up being abused or taken advantage of due to her lack of understating. They approach you as a doctor to provide a certificate so that the parents can ask for a hysterectomy. You tell them that this is against human rights and in fact, there is a court judgment against this practice but they keep insisting, because they see you both as a doctor as well as a friend. What should you do?

a) Go all out to help them for the operation because you feel that times are actually bad and chances of (possible) rape and pregnancy are high?
b) Go by the book and say there is nothing you can do?
c) Suggest alternative treatments?

Any other suggestions and solutions? Do write in!

Responses received

It is the responsibility of the mother to protect her from sexual abuses and subsequent pregnancy as she cannot take care of herself. The best course would be to get a certificate from psychologist that she is mentally unfit and cannot take care of herself. Then she should get her operated for tubectomy to save her from subsequent pregnancy and then get her treated by some psychologist for her mental illness. If she recovers and becomes mentally fit she may get her operated for reversal of procedure, reuniting the tubes. This will give her a chance of getting pregnant which is very important factor for any lady. Hysterectomy will be a permanent failure to get the child of her own, which becomes unethical. Dr BR Bhatnagar
IMA Digital TV
Inspirational Story
Be a Good Friend

One day, when I was a freshman in high school, I saw a kid from my class was walking home from school. His name was Kyle. It looked like he was carrying all of his books. I thought to myself, "Why would anyone bring home all his books on a Friday? He must really be a nerd."

I had quite a weekend planned (parties and a football game with my friends tomorrow afternoon) so I shrugged my shoulders and went on. As I was walking, I saw a bunch of kids running toward him. They ran at him, knocking all his books out of his arms and tripping him so he landed in the dirt. His glasses went flying, and I saw them land in the grass about ten feet from him. He looked up and I saw this terrible sadness in his eyes

My heart went out to him. So, I jogged over to him as he crawled around looking for his glasses, and I saw a tear in his eye. As I handed him his glasses, I said, "Those guys are jerks. They really should get lives." He looked at me and said, "Hey thanks!" There was a big smile on his face. It was one of those smiles that showed real gratitude.

I helped him to pick up his books, and asked him where he lived. As it turned out, he lived near me, so I asked him why I had never seen him before. He said he had gone to private school until now. I had never hung out with a private school kid before. We talked all the way home, and I carried some of his books. He turned out to be a pretty cool kid.

I asked him if he wanted to play a little football with my friends, he said yes. We hung out all weekend and the more I got to know Kyle, the more I liked him, and my friends thought the same of him. Monday morning came and there was Kyle with the huge stack of books again. I stopped him and said, "Boy, you are gonna really build some serious muscles with this pile of books everyday!"

He just laughed and handed me half the books. Over the next four years, Kyle and I became best friends. When we were seniors we began to think about college. Kyle decided on Georgetown and I was going to Duke. I knew that we would always be friends, that the miles would never be a problem. He was going to be a doctor and I was going for business on a football scholarship.

Kyle was valedictorian of our class. I teased him all the time about being a nerd. He had to prepare a speech for graduation. I was so glad it wasn’t me having to get up there and speak. Graduation day, I saw Kyle. He looked great. He was one of those guys who really found himself during high school.

He filled out and actually looked good in glasses. He had more dates than I had and all the girls loved him. Boy, sometimes I was jealous! Today was one of those days. I could see that he was nervous about his speech. So, I smacked him on the back and said, "Hey, big guy, you’ll be great!" He looked at me with one of those looks (the really grateful one) and smiled. "Thanks!" he said. As he started his speech, he cleared his throat, and began:

"Graduation is a time to thank those who helped you make it through those tough years. Your parents, your teachers, your siblings, maybe a coach…but mostly your friends… I am here to tell all of you that being a friend to someone is the best gift you can give them. I am going to tell you a story."

I just looked at my friend with disbelief as he told the story of the first day we met. He had planned to kill himself over the weekend. He talked of how he had cleaned out his locker so his mom wouldn’t have to do it later and was carrying his stuff home.

He looked hard at me and gave me a little smile. "Thankfully, I was saved. My friend saved me from doing the unspeakable." I heard the gasp go through the crowd as this handsome, popular boy told us all about his weakest moment.

I saw his Mom and dad looking at me and smiling that same grateful smile. Not until that moment did I realize its depth.

Never underestimate the power of your actions. With one small gesture you can change a person’s life…for better or for worse. God puts us all in each other’s lives to impact one another in some way.
Over 50 doctors attended the IMA Rise & Shine CME on Vitamin D deficiency in Jorhat
Over 300 doctors attended the IMA Rise & Shine CME on Vitamin D deficiency in Dhule
eMedi Quiz
Which of the following are true about restless leg syndrome?

1. RLS also occurs at rest
2. RLS is predominantly in the evening or at night
3. RLS is sometimes painful.
4. All of the above

Yesterday’s Mind Teaser: True of false, if false the reason

Difference between Peripheral vascular disease and leg cramps is that PVD may result in cramp-like leg pain in a pattern of intermittent claudication, which occurs during limb use and is relieved by rest, unlike leg cramps.

Answer for Yesterday’s Mind Teaser: TRUE

Answers received from: Dr Kailash Chandra Sharma, Dr Praneet Telukunta, Dr Jainendra Upadhyay, Daivadheenam Jella, Dr K V Sarma, Dr Avtar Krishan.

Answer for 1st December Mind Teaser: TRUE

Answers received from: Dr A C Dhariwal, Dr Bharat Bhushan Aggarwal, Dr Jainendra Upadhyay, Dr Poonam Chablani, Daivadheenam Jella, Dr Avtar Krishan.
Hypochondriac – a person wants to have her ache and treat it too
Readers column
Dear Sir, very good inspiration story. Regards: Dr Shravn
Press Release
Avoid in-person visits to your family doctor this flu season to prevent the infection from spreading to others

IMA recommends that people suffering from mild flu should make use of various available telemedicine avenues to seek tips on disease management

In every country that experiences winter, there’s a flu season. The reason for this is that the influenza virus flourishes in cold, dry weather. In addition to this, cold air and low levels of humidity act as ideal transmitters of the influenza virus from one person to another.

With the onset of winter in India, every third person is found suffering from fever, a cough or cold. The number of patients doctors see on a daily basis has also doubled. Given how fast the influenza virus spreads from one person to another, the Indian Medical Association recommends that people suffering from mild flu should seek medical advice through telemedicine solutions like those provided by healthcare consultancies like Lybrate. By doing this in place of making an in-person visit to their doctor, the spread of the disease can be curtailed by over 50%.

Considering that flu season makes it appearance on a yearly basis, the sheer lack of awareness that exists about its causes, risk factors, symptoms and cure is surprising. Outbreaks of new strains of flu including the recent ‘Swine Flu outbreak’ have made the situation worse causing widespread panic. People are now seen flocking to hospitals not realizing the risks that they run of infecting others present there as well as contracting new viruses and ailments.

Clearing misconceptions, Padma Shri Awardee Dr. A Marthanda Pillai – National President and Padma Shri Awardee Dr. K K Aggarwal, Honorary Secretary General Indian Medical Association in a joint statement said, “It is important that awareness is raised about what flu is and ways to prevent and tackle it. First and foremost, in the absence of fever, it can be safely assumed that the person is not suffering from the flu. A flu patient will always show symptoms of a cough, cold and fever. A cough and cold without fever can be a simple allergy, which can be cured with antihistamines. Phone/web-based consultation can be sought for mild flu cases. However, if a person experiences breathlessness along with the flu, he or she must be immediately admitted to a hospital".

It is also important to remember that antibiotics are not required for the treatment of flu. They should be administered to only those patients who have a sore throat along with fever. It is recommended that high-risk patients take the flu vaccine every year to prevent contracting the disease.

“One must stay 3 – 6 feet away from a patient suffering from the flu to avoid contracting the infection. It is also important to regularly wash your hands during the flu season. Patients suffering from the flu should not cough in their hand or handkerchief. Instead, a tissue paper should be used, and when not available, they can cough on their sleeve. Maintaining proper hand and respiratory hygiene is a must”, Dr. K K Aggarwal added.

Online medical consultation is permissible by International laws and regulations as long as it is sought from registered medical practitioners. It is a good medium of seeking advice for mild conditions such as common cold and flu, which are contagious as well as for second opinions. Mild flu typically requires no anti-viral drugs and no detailed investigation. It is thus possible for doctors to share basic preventive and disease management information through these online platforms without putting their other patients and themselves at risk of contracting the infection.