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FIRST NATIONAL 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 …

4th December 2012, Tuesday

Statins and risk of infection

Earlier studies had suggested that prior treatment with statins might reduce the risk of serious infections or improve outcomes in patients with serious infections.

A meta-analysis of 11 randomized trials of statins (n = 30,947) found no effect of statin therapy on infections or infection related mortality. (BMJ 2011; 343:d7281.)

For Comments and archives…

Dr KK Aggarwal
Group Editor in Chief

   Constipation Update

Stool softeners, suppositories (glycerin or bisacodyl) and enemas have limited clinical efficacy and should only be used in specific clinical scenarios.

 
Dr K K Aggarwal
  eMedinewS Audio PostCard

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

Monitoring LFT in a patient on statins

Audio PostCard
    Photo Feature (from the HCFI Photo Gallery)

1430 MCD schoolchildren learn hands-only CPR 10

In an attempt to train one lakh people in the current year, Heart Care Foundation of India today trained 1430 children and teachers of MCD Primary Boys School Tuglakabad Village, in hand-only CPR10. The training was conducted by Padma Shri and Dr B C Roy National Awardee, Dr K K Aggarwal, President Heart Care Foundation of India.

 
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

US FDA approval should not be a marker for stent quality

India is witnessing an alarming increase in the number of heart attacks. An estimated 24 lakhs deaths occur annually due to heart attacks. Despite this disturbing scenario, the treatment is still out of reach of the common man. The treatment costs are high and the most important reason for this high cost of treatment is the use of treatment devices such as stents, balloon etc., which continue to be imported from the US and European countries. Drug-eluting stents (DES), which are used to open the blocked arteries, form the major component of the treatment costs of angioplasty. In India, over 70% of these DES are still imported from the US and Europe. But, the scenario in China is different, where more than 80% of DES used are manufactured locally. This is so because the Government policies in China favor domestic manufacturers as China aims to be completely self-sufficient for treating cardiac diseases with locally manufactured devices within the next 2-3 years.

The largest medical treatment reimbursement agency in India is the CGHS i.e. Central Government Health Scheme (CGHS). It is the main body that fixes reimbursement rates for these expensive DES and these rates are followed by most other reimbursement and insurance bodies. The ceiling rates for coronary stents were revised by the CGHS in October 2011. This revision provides for higher prices to US FDA-approved products and least prices to products approved by the Drug Controller General of India.

Padma Shri and Dr BC Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India said that this discrimination creates a perception among the common man that only the US FDA approved stents are the best, followed by the European CE approved and the non FDA, non CE approved stents, which includes Indian manufactured DES are the worst stents.

Once a stent has been approved by any International agency, the pricing must be equal. The least India can do is to promote and give preference to Indian manufacturers who are working towards and wish to create world class products. There should be no difference in the pricing of stents. An ideal scenario would be to lower the prices of Indian stents, but granting higher reimbursements to US manufactured stents takes away this advantage.

The present system of reimbursement by CGHS is:

  • Category 1 US FDA approved: Rs 65,000/-
  • Category 2 CE marked stents: Rs 50,000/-
  • Category 3 Indian DCGI: Rs 40,000/-

The criteria for approval should ideally be clinical data for the product and not any country specific approvals. All Indian stents which can prove equivalence with the US made DES should be categorized along with the US FDA approved stents and must be given higher reimbursements to level the playing field.

USFDA approval is given only to those companies wanting to launch their products in USA. Many companies that are not based in the US may have better technologies, yet do not wish to launch their products in the US markets because of the high costs of conducting trials and selling and many companies cannot afford to bear these high costs. That the US FDA too exhibits a subtle biasness towards US companies is evident from the fact that no DES manufactured outside of the US has been approved in the last 10 years. Some old generation US FDA-approved stents are still being used in India but the same have been withdrawn for use in other countries. This is because US FDA approval once granted remains for the lifetime of the product despite the availability of better technologies.

US multinationals are now clearing away their old generation products and shipping them to India under the USFDA product category under CGHS scheme which grants them high pricing compared to CE mark products. The CE mark, which is a mandatory conformity mark for products placed on the market in the European Economic Area (EEA), is a fair quality criterion as it is accessible to Indian companies and follows the GHTF (Global Harmonized Task Force) quality standards and parameters commonly adopted by European Union, USA, Australia and Canada. Unlike the US FDA, the CE mark is non-discriminatory and Indian companies can also acquire it by improving their manufacturing and quality standards and ensuring that their products meet all the CE mark requirements.

DES are priced higher in India than rest of the world. The prices of these stents are fast degrading in the global market.

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 sclerosis in end stage renal disease is associated with progressive stenosis and increased cardiovascular mortality.

(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)

 
    International News

(Contributed by Dr Monica and Brahm Vasudev)

First-in-class insomnia treatment headed for approval?

A new study suggests that suvorexant (Merck & Co. Inc), the first agent of its kind that works on the orexin signaling pathway to selectively dampen unwanted wakefulness, could be a safe and effective alternative to current treatments for insomnia. (Source: Medscape)

FDA approves cabozantinib for medullary thyroid cancer

The US Food and Drug Administration (FDA) today approved cabozantinib (Cometriq, Exelixis), for the treatment of metastatic medullary thyroid cancer. (Source: Medscape)

Unique injury pattern points to elder abuse

Think elder abuse when an older person presents to the emergency department or the doctor's office with a subdural hematoma, bruises to the head and neck, maxillofacial and dental injuries, and upper extremity injuries, researchers said here at the Radiological Society of North America 98th Scientific Assembly and Annual Meeting. Those types of injuries, along with a wasted and unkempt appearance, are almost sure signs that the person is a victim of physical abuse, said Kieran Murphy, MD, acting chief of radiology at the University Health Network, Toronto General Hospital, in Ontario, Canada.

FDA panel endorses novel tuberculosis drug

A federal advisory panel voted unanimously yesterday 18 to 0 for efficacy but split 11 to 7 on safety in support of accelerated approval of a novel drug to combat multidrug-resistant tuberculosis (MDR-TB). The US Food and Drug Administration's (FDA's) Anti-Infective Drugs Advisory Committee agreed with Janssen Therapeutics, a division of Janssen Products, LP, that the manufacturer's drug bedaquiline could be approved on the basis of phase 2 data using the surrogate study endpoint of sputum culture conversion rather than clinical cure because of the unmet treatment need. Bedaquiline works via a novel mechanism of action: inhibition of a mycobacterial enzyme that is essential to the bacteria's action. The proposed drug indication is a part of combination therapy for the treatment of pulmonary TB caused by MDR Mycobacterium tuberculosis in adults, to be administered under directly observed therapy. (Source: Medscape)

 
    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

@DeepakChopra: Creativity & imagination exist eternally in consciousness. Their perceptual manifestation is a never ending horizon

 
    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)

1. What is Endometriosis?

Endometriosis is a common condition that affects women during the reproductive years. It occurs when normal tissue from the uterine lining, the endometrium, attaches to organs in the pelvis and begins to grow. This displaced endometrial tissue causes irritation in the pelvis that may lead to pain and infertility.

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

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

ABO/Rh Problems

Solving discrepancies

Check samples - redraw

Get a history, including drugs

Wash cells - patient and reagent

Retest using A2 and O cells

Clean glassware

Check reagents - outdated or hemolyzed

Correct room temperature and increase incubation

 
    An Inspirational Story (Dr GM Singh)

A touching story from a father

My wife called, 'How long will you be with that newspaper? Will you come here and make your darling daughter eat her food?' I tossed the paper away and rushed to the scene. My only daughter Sindu looked frightened.

Tears were welling up in her eyes. In front of her was a bowl filled to its brim with Curd Rice. Sindu is a nice child, quite intelligent for her age. She has just turned eight. She particularly detested Curd Rice. My mother and my wife are orthodox, and believe firmly in the 'cooling effects' of Curd Rice! I cleared my throat, and picked up the bowl.

'Sindu, darling, why don't you take a few mouthful of this Curd Rice? Just for Dad's sake, dear. Sindu softened a bit, and wiped her tears with the back of her hands. 'OK, Dad. I will eat - not just a few mouthfuls, but the whole lot of this.

But, you should...' Sindu hesitated. 'Dad, if I eat this entire curd Rice, will you give me whatever I ask for?'....

Oh sure, darling'.... 'Promise?'......... 'Promise'. I covered the pink soft hand extended by my daughter with mine, and clinched the deal. 'Ask Mom also to give a similar promise', my daughter insisted.

My wife put her hand on Sindu's, muttering 'Promise'. Now I became a bit anxious. 'Sindu dear, you shouldn't insist on getting a computer or any such expensive items. Dad does not have that kind of money right now. OK?' 'No, Dad. I do not want anything expensive'.

Slowly and painfully, she finished eating the whole quantity.

I was silently angry with my wife and my mother for forcing my child to eat something that she detested. After the ordeal was through, Sindu came to me with her eyes wide with expectation. All our attention was on her.

'Dad, I want to have my head shaved off, this Sunday!' was her demand.

'Atrocious!' shouted my wife, 'A girl child having her head shaved off? Impossible!' 'Never in our family!' my mother rasped.

'She has been watching too much of television. Our culture is getting totally spoiled with these TV programs!'

Sindu darling, why don't you ask for something else? We will be sad seeing you with a clean-shaven head.'

'No, Dad. I do not want anything else', Sindu said with finality.

'Please, Sindu, why don't you try to understand our feelings?'

I tried to plead with her.

'Dad, you saw how difficult it was for me to eat that Curd Rice'.

Sindu was in tears. 'And you promised to grant me whatever I ask for.

Now, you are going back on your words. Was it not you who told me the story of King Harishchandra, and its moral that we should honor our promises no matter what?'

It was time for me to call the shots. 'Our promise must be kept.' 'Are you out your mind?' chorused my mother and wife.

'No. If we go back on our promises, she will never learn to honor her own. Sindu, your wish will be fulfilled.'

With her head clean-shaven, Sindu had a round-face, and her eyes looked big and beautiful.

On Monday morning, I dropped her at her school. It was a sight to watch my hairless Sindu walking towards her classroom. She turned around and waved. I waved back with a smile. Just then, a boy alighted from a car, and shouted, 'Sinduja, please wait for me!'

What struck me was the hairless head of that boy.

'May be, that is the in-stuff', I thought. 'Sir, your daughter Sinduja is great indeed!' Without introducing herself, a lady got out of the car, and continued,' that boy who is walking along with your daughter is my son Harish. He is suffering from... ... leukemia.' She paused to muffle her sobs.

Harish could not attend the school for the whole of the last month. He lost all his hair due to the side effects of the chemotherapy. He refused to come back to school fearing the unintentional but cruel teasing of the schoolmates.

'Sinduja visited him last week, and promised him that she will take care of the teasing issue. But, I never imagined she would sacrifice her lovely hair for the sake of my son! Sir, you and your wife are blessed to have such a noble soul as your daughter.'

I stood transfixed. And then, I wept. 'My little Angel, you are teaching me how self-less real love is!'

The happiest people on this planet are not those who live on their own terms but are those who change their terms for the ones whom they love…

For comments and archives

 
   Cardiology eMedinewS

Injectable used in heart studies recalled Read More

Heart risk from preeclampsia tied to number of kids

 
   Pediatric eMedinewS

Finger length a marker of verbal aggression? Read More

Overuse of cell phones: An addiction like any other? Read More

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient came with psoriatic arthritis.
Dr Bad: Don’t worry. It has no association with heart disease.
Dr Good: You are at risk of developing heart disease as well as diabetes.
Lesson: There is accumulating evidence showing a relationship between psoriasis and an increased risk of developing cardiovascular risk factors, including diabetes mellitus type 2 and ischemic heart disease. The highest risk of suffering from diabetes mellitus type 2 among psoriatic patients is in patients suffering from non-familial and late-onset disease and in patients suffering from psoriatic arthritis. Australas J Dermatol 2012 May;53(2):128-30.

Make Sure

Situation: A patient with acute fever developed acute bleeding after aspirin was given.
Reaction: Oh my God! Why was dengue not ruled out?
Lesson: Make sure that all patients with acute febrile illness are evaluated for dengue as low platelets count can precipitate bleeding in them, if aspirin is given to reduce fever.

 
  Quote of the Day (Dr GM Singh)

When life gives you a hundred reasons to cry, show life that you have a thousand reasons to smile.

 
  Legal Question of the Day (Dr MC Gupta)

Q. The DMC and DMA have failed miserably to combat the quackery menace. CEA is the last hope which, if implemented in right earnest, may save masses from these harmful self- styled Jhola Chhap doctors. But how long we will have to depend on courts and consumer forums? When will the DMC, DMA etc. rise to the occasion and become proactive and effective?

Ans.

You have raised many vital issues. My response is as follows.

A. The Delhi Medical Council has failed miserably because it is manned by men without a strong conviction as regards conscience, principles, justice and probity. My statement is based upon the following facts:

  • The DMC avoids dealing with complaints against doctors in a legally correct manner. EXAMPLES:
    • Section 27 is wrongly worded in an anomalous manner and makes it impossible to take action against cross pathy. This anomaly has been pointed out to the DMC repeatedly but they refuse to take any action.

      Section 27 reads—

      “27. False assumption of Medical Practitioner or Practitioner under this Act to be an offence

      Any person who falsely assumes that he is a medical practitioner or practitioner as defined in clause (7) of section 2 and practices the modern scientific system of medicine, shall be punishable with rigorous imprisonment which may extend up to three years or with fine which may extend up to Rs.20,000 or with both.

      Explanation: Under this section, punishment can be awarded only to medical practitioners as defined in section 2(7) of this Act and no punishment may be awarded to any one practicing Veterinary medicine or Veterinary surgery or Homoeopathic or the Ayurvedic or the Siddha or the Unani System of medicine or those holding BAMS or BIMS degree….. clearly says/implies that if Section 15(6) of DMC Act, 1997, needs to be modified because it is in violation of section 27 of IMC Act, 1956. The DMC knows it but has done nothing.”
    • Rule 32 of the DMC Rules, 2003, needs to be modified for the following reason:
      • The rule provides that the quorum for a meeting of the disciplinary committee will consist of “the chairman disciplinary committee and at least two members thereof sitting together”.
      • The above condition could as well be fulfilled if the members present at the meeting merely consist of the chairman disciplinary committee and along with the members listed at serial no. (ii) and (iv) in section 21(1) of the DMC Act, 1997. The members listed at serial no. (ii) and (iv) are, respectively, an MLA and a public man. This will be a travesty of justice and has potential for unjust and arbitrary and wrong decisions on the part of the DMC.
      • The modification needed is that Rule 32 ought to provide that no meeting of the disciplinary committee will be complete unless it has at least the following two persons, namely, the members listed at serial no. and (v) in section 21(1) of the DMC Act, 1997. The members listed at serial no. (iii) and (v) are, respectively, a legal expert and a medical expert.
    • DMC violates the DMC Act, 1997, in that it often appoints the inquiry committee in disregard of section 21(1) and section 21(7).
    • DMC violates the DMC Rules, 2003, in the following respects:
      • DMC violates Rule 32 of the DMC Rules, 2003, in that it often entertains, without giving reasons, complaints which do not fulfill the requirements laid down therein.
      • DMC further violates Rule 32 of the DMC Rules, 2003, in that it often allows persons other than the parties to the inquiry to be present.
    • DMC violates the Code of Ethics Regulations, 2002, in the following respects:
      • DMC violates Regulation 1.3.2 read with regulation 7.2 in that when complaints are made against physicians for not providing medical record, the DMC takes no action against the physician.
      • DMC violates Regulation 2.4 of the Code of Ethics Regulations, 2002. In respect of cases where the licence to practice is cancelled/suspended, the DMC asks the physician concerned to stop treatment of patients immediately. Regulation 2.4 states that once having undertaken a case, the physician should not withdraw from the case without giving adequate notice to the patient and his family.
      • DMC violates Regulation 8.2 of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, read with section 21(7)(b) of DMC Act, 1997, in that it insists on personal appearance of doctors and does not allow doctors to appear through their advocates. In one instance, such permission was refused even when the physician concerned, a 75-80 years old lady doctor who had had bilateral knee transplant surgery, requested for the same, stating that she was in great pain and could not go to the fourth floor where the DMC office is situated.
      • DMC violates Regulation 8.8 of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, in that it does not allow the 60 days’ time for appeal provided therein.
    • The DMC has no guidelines to determine the quantum of punishment in case they find that a doctor is guilty.
    • The criterion used by the DMC to determine who can call himself a cardiologist is irrational. This is clear from the following facts:
      • In an order, DMC held that “…since Respondent no. 1(the appellant herein) is not a holder of requisite postgraduate qualification of DM (Cardiology), he cannot claim himself to be a cardiologist per se”.
      • The members of DMC itself claim to be cardiologists without having a DM degree.
    • DMC gives patently wrong decisions without application of mind as would be clear from two examples, though I have several more:
      • Blatant Negligence missed—The hospital case sheet submitted to the DMC stated clearly that IV Lasix was given as bolus injection 1 g. every 2 minutes over 10 minutes (total 5000 mg.) to a 70 years old otherwise healthy non-cardiac patient undergoing arthroscopy of knee who happened to suddenly develop some arrhythmia suspected to be pulmonary edema. He died within 40 minutes. His son complained to DMC. The DMC found no negligence.
      • Negligence manufactured—The licence of an anesthetist was cancelled for 6 weeks while 6 anesthesia professors/consultants found no negligence. The post mortem examination has showed RVH and IVS hypertrophy which are typical of congenital cardiomyopathy, in which condition the first symptom can be death precipitated by sudden arrhythmia, as per Harrison. The autopsy report was available to the DMC. They ignored it. I had to get the DMC order quashed by going to the HC.
    • The orders given by the DMC are non-transparent about the names of the persons who heard the parties and gave decision. The constitution of the inquiry committee should be clearly spelled out in the order of the DMC. The inquiry conducted by the DMC is a quasi-judicial inquiry. Even the Supreme Court judgments are transparent and clearly state the names of the judges hearing and deciding a case.
    • The orders given by the DMC are often summary orders. They ought to be speaking orders.
    • Illegal gratification—Several doctors have personally told me that money is demanded for favourable opinions/orders in respect of complaints made to the DMC.
    • When the punishment awarded by the DMC have been quashed by the MCI or the High Court and the physician concerned has been found not to be negligent, even then the DMC continues to show him as guilty on its web site along with the nature of punishment. The DMC should rectify this immediately.
  • You are right that the DMA has failed miserably. However, it is not because of lack of knowledge or power to Act. It is because of the lack of will to act. All actions of the DMC are duly supported by the DMA whose nominee is always a member of the DMC disciplinary committee.
  • You have asked—“But how long we will have to depend on courts and consumer forums? When will the DMC, DMA etc. rise to the occasion and become proactive and effective?”

    The plain and real answer is—“As long as the DMC and DMA etc. continue to ignore and avoid law, lawyers and legal advice.”

    They avoid lawyers in the inquiries because they cannot lord over lawyers or insult and humiliate or subjugate or brow-beat them as they can do with doctors who are often subservient, even spineless before the council. I call them spineless because they knowingly allow their rights to be trampled. I joined the bar in 2001 and have, since then, advised doctors to approach the HC if they are denied the right to be represented by their lawyer. They are too afraid to challenge the DMC against its crass injustice. (BTW, a WP in this connection is likely to be filed soon).

    They avoid law because law would not allow them to do illegal things. Illegal acts are often associated with illegal gains. They avoid legal advice because such advice is often not to their liking.
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    Mind Teaser

Read this…………………

The physician orders on a client with CHF a cardiac glycoside, a vasodilator, and furosemide (Lasix). The nurse understands Lasix exerts is effects in the:

A. Distal tubule
B. Collecting duct
C. Glomerulus of the nephron
D. Ascending limb of the loop of Henle

Yesterday’s Mind Teaser: 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

Answer for Yesterday’s Mind Teaser: d. Potential alteration in renal perfusion

Correct answers received from: Dr BB Aggarwal, Dr Kanta Jain, Dr Valluri Ramaro, Dr PC Das,
Dr K Raju, Dr (Maj. Gen.) Anil Bairaria, Dr Pankaj Agarwal, Muthumperumal Thirumalpillai, Dr KV Sarma,
Dr Jainendra Upadhyay, Dr Chandresh Jardosh, Dr Avtar Krishan, Dr Thakor Hitendrsinh G, Dr Uma Gaur,
Dr R K Goel, Dr PC Das, Dr K Raju, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai.

Answer for 2nd December Mind Teaser: B. This indicates that the bladder is distended with urine, therefore palpable

Correct answers received from: Dr KV Sarma, Dr RK Goel, Dr PC Das, Dr K Raju, Dr MC Srivastava,
Dr Thakor Hitendrsinh G, Dr Avtar Krishan, Dr Pankaj Agarwal, Dr Chandresh Jardosh, Dr Jainendra Upadhyay, Muthumperumal Thirumalpillai, Dr B K Agarwal, Dr KV Sarma, Dr PC Das, Dr Kanta Jain.

Send your answer to ijcp12@gmail.com

 
    Laugh a While (Dr GM Singh)

Mass hysteria

A professor of clinical psychology at Victoria University in Wellington, New Zealand, included a lecture on crowd psychology in his annual course. To illustrate mass hysteria, he regularly showed TV news footage of teenage crowds greeting the Beatles at the local airport in the 1960's.

One year, when he ran the footage, he heard squeals and bursts of laughter from his students. When the film ended he asked what had caused the hilarity.

Replied one student, "We recognized some of our mothers!"

 
  Medicolegal Update

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

Triage in medical care & emergency treatment - Can a doctor ignore a routine appointment if a serious patient arrives?

The term ‘triage’ is a French word used in military medical services, which refers to the process of sorting injured/sick patient on the basis of urgency/priority of treatment. Triage in trauma care/emergency department is a very quick/necessary decision to first evacuate those with best chance of survival and to leave for later evacuation those who had little or no chance of survival. The doctors’ right to decide the issue of priority of attending the patients has been upheld by the Consumer Disputes Redressal Agencies (CDRAs).

The right of medical doctor is an important aspect of medical practice as often the patient’s perception of emergency differs from that of Doctors. In BS Hegde v Dr Sudhanshu Bhattacharya, the National Commission held that a doctor has the absolute right to decide which patient he would examine first and even out of turn depending on the condition of the patient. There is nothing improper or unreasonable if the doctor gives precedence to patients with active/acute cardiac problem/other medical/surgical condition where urgent medical attention of doctor is called for in preference to the routine consultation. In addition, it cannot be held that the patients must be examined at the appointed time irrespective of the time he may have to spend in examining the previous patients. (George, James E, Law and emergency care, The CV Mosby Co, St.Louise,1980 pp 66–67)

 
    Public Forum

(Press Release for use by the newspapers)

1430 MCD schoolchildren learn hands-only CPR 10

In an attempt to train one lakh people in the current year, Heart Care Foundation of India today trained 1430 children and teachers of MCD Primary Boys School Tuglakabad Village, in hand-only CPR10. The training was conducted by Padma Shri and Dr B C Roy National Awardee, Dr K K Aggarwal, President Heart Care Foundation of India.

Municipal Councilor Chote Ram and Mr Jagdish Principal of the school, who were present on the occasion, said that even primary school children should lean this technique.

The Foundation has already trained over 20,000 people since 1st November. A 16-year-old female student of Birla Vidya Niketan has already saved one life, her uncle, by doing successful CPR.

Hands-only CPR 10 is based on the Formula of 10 “Within 10 minutes of clinical death, for the next 10 minutes, compress the center of the chest with a speed of 10x10, or 100 per minute.”

This is for the first time that the whole school including all students and staff has been trained in CPR.

 
    Readers Response
  1. Dear Sir, emedinews is very interesting. Regards: Dr Tapan
 
    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

 
    eMedinewS Special

1. IJCP’s ejournals (This may take a few minutes to open)

2. eMedinewS audio PPT (This may take a few minutes to download)

3. eMedinewS audio lectures (This may take a few minutes to open)

4. eMedinewS ebooks (This may take a few minutes to open)

HCFI
Activities eBooks

  DIET BOOK

  HCFI

  Playing Cards

  Dadi Ma ke Nuskhe

  Personal Cleanliness

  Mental Diseases

  Perfect Health Mela

  FAQs Good Eating

  Towards Well Being

  First Aid Basics

  Dil Ki Batein

  How to Use

  Pesticides Safely

 
    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