May 3  2015, Sunday
editorial
You Can Reverse Heart Disease
Every cell in the body eventually dies and is replaced by a new cell. Every day is a new opportunity to build a new body. The entire body totally rebuilds itself in less than two years with 98% in less than one year. Dr KK Aggarwal
  • Stomach lining rebuilds itself in 5 days.
  • The skin rebuilds itself in 1 month.
  • Liver rebuilds itself in 6 weeks.
  • Your DNA rebuilds itself every 2 months.
  • Bone rebuilds the whole new skeleton in 3 months.
  • Blood rebuilds itself in 4 months.
  • Brain rebuilds itself in 1 year.
You cannot swim in the same river twice. With every breath, we inhale 1022 atoms coming from all cells present in the universe. We share everything with everybody with every breath. Quadruplet atoms in the last three weeks have gone through our breath. Billion atoms out of them may have been those of Christ or Mohammad.

The very fact that our body rebuilds itself, it is possible to change the Dharma of the new cells and even prevent or even regress cancers and heart diseases.
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eMedipics IMA,IJCP,HCFI
Team IMA at Nepal relief camp
News
  • The US Food and Drug Administration (FDA) has approved the combination of fluticasone furoate/vilanterol for the once-daily treatment of asthma in adults aged 18 years and older.
  • The first study of human neural stem cells delivered directly to the brain in patients with stroke has shown no major harmful cell-related effects over 2 to 4 years' follow-up, with a suggestion of slight improvements in patient functionality. The findings were presented at the European Stroke Organisation (ESO) Conference 2015.
  • For the first time, a study has shown a link between the consumption of sweetened milk drinks and type 2 diabetes, indicating that efforts to reduce intake of sugar-sweetened beverages (SSBs) should be extended to include milkshakes and flavored milk. The findings are published online April 30 in Diabetologia.
  • The 13-valent conjugated pneumococcal vaccine (PCV13) commonly used in children is effective in older adults for the prevention of vaccine-type community-acquired pneumonia and invasive pneumococcal disease, with the effect lasting for at least 4 years, suggests one of the largest vaccine efficacy trials in history, presented at the 25th European Congress of Clinical Microbiology and Infectious Diseases.
  • The US Food and Drug Administration (FDA) today approved deoxycholic acid to help reduce double chins. The approval follows a unanimous vote on March 9 by the FDA's Dermatologic and Ophthalmic Drugs Advisory Committee in favor of deoxycholic acid injection for improvement in the appearance of moderate to severe convexity or fullness associated with submental fat in adults.
  • Almost half of antibiotic prescriptions by general practitioners for respiratory tract indications (RTIs) failed to comply with clinical guidelines, according to new research published online April 24 in Family Practice. The most dominant factor driving unnecessary antibiotic prescriptions was patient expectations
  •  All hospitals should develop a comprehensive violence prevention program. No universal strategy exists to prevent violence. The risk factors vary from hospital to hospital and from unit to unit. Hospitals should form multidisciplinary committees that include direct-care staff as well as union representatives (if available) to identify risk factors in specific work scenarios and to develop strategies for reducing them. All hospital workers should be alert and cautious when interacting with patients and visitors. They should actively participate in safety training programs and be familiar with their employers' policies, procedures, and materials on violence prevention.
  • MCI 7.21 No act of invitro fertilization or artificial insemination shall be undertaken without the informed consent of the female patient and her spouse as well as the donor. Such consent shall be obtained in writing only after the patient is provided, at her own level of comprehension, with sufficient information about the purpose, methods, risks, inconveniences, disappointments of the procedure and possible risks and hazards.
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Dr KK Spiritual Blog
Mindfulness meditation

Sit on a straight–backed chair or cross–legged on the floor.

Focus on an aspect of your breathing, such as the sensation of air flowing into your nostrils and out of your mouth, or your belly rising and falling as you inhale and exhale.

Once you’ve narrowed your concentration in this way, begin to widen your focus. Become aware of sounds, sensations, and ideas.

Embrace and consider each thought or sensation without judging it good or bad. If your mind starts to race, return your focus to your breathing. Then expand your awareness again.
Cardiology eMedinewS
  • Traumatic life events could increase the risk of heart attack by more than 65% in middle-aged and older women, suggests a new study scheduled to be presented at the Quality of Care and Outcomes Research 2015 Scientific Sessions.
  • A new study, published in the Journal of the American Heart Association, suggests that acute heart failure patients are more likely to die within 2 years of hospitalization if they have trouble understanding and using health information.
Pediatrics eMedinewS
  • U.S. doctors treated three infants with an often-fatal airway disease by implanting a 3-D printed medical device that improves breathing and changes shape as the children grow. The report is published in the journal Science Translational Medicine.
  • For young children undergoing heart surgery, the use of fresh whole blood from single donors may reduce the risk of lifelong complications, suggested a new study published in The Annals of Thoracic Surgery.
Make Sure
Situation: A dengue patient with BP 100/90 developed shock.
Reaction: Oh my God! Why was rapid fluid challenge not given?
Lesson: Make sure that pulse pressure (upper minus lower blood pressure) is maintained above 40 in all patients with dengue
Dr Good Dr Bad
Situation: A patient came with right heart failure.
Dr Bad: Continue with your normal fluid intake.
Dr Good: Restrict your fluid intake.
Lesson: In right heart failure, fluids should be restricted.

(Copyright IJCP)
Inspirational Story
The perfectionist sculptor

A gentleman once visited a temple under construction where he saw a sculptor making an idol of God. Suddenly he noticed a similar idol lying nearby. Surprised, he asked the sculptor, "Do you need two statues of the same idol?"

"No," said the sculptor without looking up, "We need only one, but the first one got damaged at the last stage." The gentleman examined the idol and found no apparent damage. "Where is the damage?" he asked.

"There is a scratch on the nose of the idol." said the sculptor, still busy with his work. "Where are you going to install the idol?" The sculptor replied that it would be installed on a pillar twenty feet high.

"If the idol is that far, who is going to know that there is a scratch on the nose?" the gentleman asked. The sculptor stopped his work, looked up at the gentleman, smiled and said, "I know it and God knows it!"

Moral: The desire to excel should be exclusive of the fact whether someone appreciates it or not. Excellence is a drive from inside, not outside. Excel at a task today – not necessarily for someone else to notice but for your own satisfaction.
eMedi Quiz
The blood vessel related to the paraduodenal fossa is:

1. Gonadal vein.
2. Superior mesenteric artery.
3. Portal vein.
4. Inferior mesenteric vein

Yesterday’s Mind Teaser: The commonest variation in the arteries arising from the arch of aorta is:

1. Absence of brachiocephalic trunk.
2. Left vertebral artery arising from the arch.
3. Left common carotid artery arising from brachiocephalic trunk.
4. Presence of retroesophageal subclavian artery.

Answer for yesterday’s Mind Teaser: 3.Left common carotid artery arising from brachiocephalic trunk.

Correct Answers received from: Dr.K.Raju, Daivadheenam Jella, Dr Avtar Krishan,

Answer for 1st May Mind Teaser: Unlike tamoxifen, AIs are associated with an increased risk of endometrial cancer

Correct Answers received: Daivadheenam Jella, Dr Shangarpawar, Dr Pandit Hantodkar.
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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
Rabies News (Dr A K Gupta)
What is the importance of pre-exposure vaccination?

Pre–exposure vaccination simplifies post–exposure vaccination because after bite, those who have received full pre–exposure vaccination require only two doses of vaccine at Days 0 & 3. RIG is not required (WHO 2007).
IJCP Book of Medical Records
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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
Make branded medicines cheaper, Indian Medical Association requests health ministry
Prices of branded drugs available in India should be brought down closer to the prices of their generic alternatives, requests a letter from the Indian Medical Association (IMA) addressed to the union health ministry.

Prices of branded drugs available in India should be brought down closer to the prices of their generic alternatives, requests a letter from the Indian Medical Association (IMA) addressed to the union health ministry.

The letter, sent in the second week of April, also requests the ministry to assess the quality of crucial generic drugs and certify them so that doctors can prescribe them to patients without any qualms.

Dr Jayesh Lele, president-elect, IMA (Maharashtra) said, "The drug price variation (between branded and generic drugs) was one of the topics discussed in our central working committee meeting that was held a few days ago. We felt the need to have certified generic drugs so that people get the benefit."

A generic drug is identical to a brand-name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use. Although generic drugs are chemically identical to their branded counterparts, they are typically sold at substantial discounts from the branded price.

"For diseases like diabetes and hypertension, where the patients have to take medicines for the long term, generic drugs will help them save a lot. Also, if the union health ministry certifies generic drugs, people won't run behind brands, and we doctors can freely prescribe generic drugs," said Dr Lele.

In 2013, in a landmark decision, Supreme Court of India denied Novartis AG's request for patent protection for its Gleevec cancer treatment, allowing the nation's generic-drug makers to continue to sell copies of the drug at a lower price. The Medical Council of Indias (MCI) too had issued directives to its doctors to prescribe generic medicines as far as possible.

Following this, the Centre had directed all the states to ask their doctors in public facilities to prescribe only generic medicines. To promote generic drugs, more than 150 Jan Aushadhi Stores have already been opened across India

"At IMA, we are dedicated to serve our patients and concerned about the huge price differences (between branded and generic) drugs, especially antibiotics and anti-cancer drugs. We have requested the central government to look into the matter," said Dr KK Agarwal, national secretary general, IMA.

Dr Agarwal said that until the government comes out with a concrete move on drug price regulation, IMA is hiring a pharmacist who will help evaluate generic medicines. "The pharmacist will help us find cheaper and trustworthy options in drugs. The list will then be approved by our consultants, and patients can shift to the cheaper options accordingly," said Dr Agarwal.
Safe Water
  1. Unsafe drinking water can lead to diarrhea, jaundice and typhoid.
  2. About 70% of people in India do not have access to safe water.
  3. Tap water may not be safe for drinking.
  4. Ice made from tap water may not be safe for use.
  5. Vegetables washed in tap water may not be safe for consumption.
  6. Adding chlorine in water may take up to 30 minutes to kill micro-organisms that may be present in water.
  7. Putting few drops of iodine in water may take up to 30 minutes to kill micro-organisms that may be present in water.
  8. Contaminated water may be unpleasant to taste.
  9. RO (reverse osmosis) and UV (ultraviolet) treated water are safe. They kill micro-organisms and remove/dissolve impurities.
  10. Water should be rolling boiled for 1 to 3 minutes to kill micro-organisms.
  11. RO and UV water may be cheaper than buying bottle water.
  12. If RO water is put in a contaminated container, it may become contaminated.
  13. RO water should be stored in uncontaminated utensils.
  14. Vegetables should be washed in running water and not in stored water.
  15. Remember the Formula: Heat it, boil it, cook it, peel it or forget it.
  16. Hands should be washed with clean water.
  17. After washing hands, one should dry hands with a clean cloth/tissue/towel.
  18. Safe water should not be used for washing clothes.
  19. Normal water consumption is 30 ml per kg body weight.
A senior doctor of Safdarjung Hospital has been arrested for allegedly molesting a woman employee.
The doctor working with the sports injury centre was arrested for “inappropriately touching” a 24-year-old data-entry operator. The incident happened on April 7. In the complaint registered on April 25, the woman has stated that she was also forced to touch male patients’ private parts when she resisted doctor’s advances and was also threatened with dismissal. The woman was not a permanent employee but on a contract.
Soliciting patients online unethical
DC | Kaniza Garari | May 01, 2015, 01.05 am IST: Hyderabad: E-medicine, soliciting patients online and registering on websites are practices that are being questioned for ethical reasons, sparking a debate among doctors.

With many websites and mobile apps available that connect patients with doctors, there are questions being raised whether it all amounts to advertising and if they promote services directly or indirectly.

The Medical Council of India, in its code of ethics, states that soliciting patients directly or indirectly by a physician or a group of physicians is unethical.

But in the digital world, this is happening. Appointments are fixed and doctors are connected to patients online.

Dr K.K. Aggarwal, the honorary secretary of the Indian Medical Association, said, “The rules of the real world apply in the digital world as well because marketing or promoting on the Internet is not permitted in the medical profession.”

But senior doctors in the city state that in an organised set up, a mobile-based healthcare platform is created to connect to patients who are far away and require help.

Dr R. Raghu, a senior doctor, said, “The patients are being connected and their initial problems like medical queries, diagnostic reports and medical status are understood and they are counselled face-to-face via video conferencing. This is actually done in a medical set-up, like a small hospital or a clinic and it saves the patient the trouble of travelling to the city to seek the opinion of the doctor.”

A senior cardiologist calls on most of his patients on whom stent operations have been done to the health camps that he conducts in various districts of the state.

The doctor explained, “I am in touch with most of my patients via video-conferencing or via tele-medicine systems. It is only when their complaints are serious do I call them to the city hospital. After a stent operation, patients waste a lot of money travelling to the city for follow-ups. Therefore, a group of doctors has decided to organise health camps in the districts. Many of our patients find it easy to visit such camps for consultation.”

While these methods are being practiced, the IMA and also the MCI are preparing a code of ethics for doctors for practicing in the digital world.

Dr Aggarwal said, “The code is very clear that soliciting patients through websites, paying fees to agents or companies who are hosting such portals and boasting of achievements in the social media are dubbed as unethical. Those practicing this method are completely wrong.”

Senior consultant Dr Nirmal Kumar said, “The clause of medico-legal issue also requires to be considered in digital practice. If the first visit of the patient is in person, then giving advice over Internet service is agreed upon.

This is because personal examination and understanding the complete problem of the patient is required. In the organised set-ups of corporate hospitals and private practices these points are kept in mind. This is because a single death or mishap, allegedly due to negligence attributed to the advice, can land the company and also the doctor in court.”
Letter to IMA
The issue of "Putrajeevak Beej" raised by me  at Panipat on 26th April has been hotly discussed in the  Media on 1st  May.

This product openly sold over the counters, strenghthens the "Male Child Preference"  ideology,
 already deep rooted amongst  the Indian masses. 

And that is the sole cause of the declining sex ratio.

Drs all over the Country, are being imprisoned for negligible, clarical, administrative mistakes. 

Ultrasound Machines are being sealed without any showcause notice or preliminary enquiry. 

You goodself  had assured the house that central IMA will get the promoters of "Putrajeevak Beej" charge sheeted under PC-PNDT laws.

 Your strong stand on the issue and personal pursual will solve half the problems of our  Fraternity.

If still the promotors go scot free, our colleagues will keep on suffering for decades, without any crime. 

Member State IMA Committee

 PC PNDT Issues

Dr V. K. Bhatia 
Sonal Namaste
Over 200 diseases are caused by unsafe food containing harmful bacteria, parasites, viruses, chemical substances
Media
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Wellness Blog
Supplements May Cut LDL in Older Women

Postmenopausal women taking calcium and vitamin D supplements had improved lipid profiles compared with those taking placebo as per a new study.

In an analysis of data from the Women’s Health Initiative, the level of LDL cholesterol was lower by an average of 4.46 mg/dL in the women on active treatment reported Peter F. Schnatz, DO, of Reading Hospital in Pennsylvania in the journal menopause.

In addition, higher concentrations of 25–hydroxyvitamin D3 (25(OH)D3) were associated with higher levels of HDL cholesterol and lower levels of LDL cholesterol and triglycerides.
Events
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IMA Humor
Daughter in College

Did you hear about the banker who was recently arrested for embezzling $100,000 to pay for his daughter’s college education?

As the policeman, who also had a daughter in college, was leading him away in handcuffs, he said to the banker, "I have just one question for you. Where were you going to get the rest of the money?"
Reader Response
Dear Sir, Very informative news. Regards: Dr Kala
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Heart Patients Beware of Summer
Summers have arrived and the temperature rises every day. Summer brings with it, its own set of problems. Most common summer disorders are dehydration, heat cramps, heat exhaustion and heat stroke on one hand and acidity, infections, diarrhea, cholera, Typhoid and Jaundice on the other hand.

Dehydration can precipitate heart attack in susceptible individuals. The normal fluid requirement is 30 ml per kg weight, but the same needs to be increased in the summer because of the loss of fluid from sweating. Apart from water, sodium or salt is also lost. A person, therefore, needs to take more fruits during summer period. Not passing urine in eight hours, dry armpits, feeling exhausted or feeling weak are suggestive of underlying dehydration, said Padma Shri, Dr. B C Roy National Awardee & DST National Science Communication Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General IMA. Dehydration can make the blood thick and precipitate heart attack in patients with uncontrolled blood pressure or diabetes.

Walking is a necessity for heart patients and the same should be continued even during peak summer but the timing should be so chosen that peak heat periods are avoided. One can walk early in the morning or late in the evening. People taking anti-allergic pills should take special precautions as they are more likely to get heat stroke. Heat stroke is a medical emergency leading to charring of organs because of extreme internal heat. A person’s temperature may be more than 105°F.