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 and Dean Medical Education Moolchand Medcity; Chairman Ethical Committee Delhi Medical Council; Chairman (Delhi Chapter) International Medical Sciences Academy; 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 of Publications & Hony. Visiting Professor (Clinical Research) DIPSAR

 

eMedinewS Presents Audio News of the Day

Photos and Videos of 2nd eMedinewS – Revisiting 2010

For regular emedinews updates follow at www.twitter.com/DrKKAggarwal

 
  Editorial …

5th November 2011, Saturday

How to classify food poisoning depending on the onset of symptoms?

What decide the severity of food poisoning are the symptoms: exposure to a particular type of food as well as the time interval between exposure to the suspect food and the onset of symptoms.

Rapid symptoms within 6–12 hours are due to organisms that make a toxin in the food before the food is consumed. Symptoms are predominantly upper intestinal like vomiting. Examples are Staphylococcus aureus, Bacillus cereus emetic toxin and botulism.

Symptoms after 24 hours are due to pathogens that make toxin once they have been ingested. They mainly cause diarrhea that may be watery (Vibrio cholerae or E. coli) or bloody (Shiga toxin–producing E. coli).

Symptoms after variable time are due to microbes that cause pathology by either damaging the epithelial cell surface or by actually invading across the intestinal epithelial cell barrier. They can produce a wide spectrum of clinical presentations from watery diarrhea (Cryptosporidium parvum, enteric viruses) to inflammatory diarrhea (Salmonella, Campylobacter, Shigella) or systemic disease (L. monocytogenes).

Food poisoning can also be classified depending on the type of symptoms vomiting or diarrhea. A sudden onset of nausea and vomiting is likely due to the ingestion of a preformed toxin, such as S. aureus enterotoxin or B. cereus emetic toxin, or a chemical irritant. There is no risk of person–to–person spread.

When the poisoning presents with diarrhea, the likely organisms are V. cholerae, Clostridium perfringens, enterotoxigenic E. coli (ETEC), B. cereus, rotavirus, astroviruses, enteric adenoviruses, and Noroviruses, and the parasitic organisms, Cryptosporidium parvum and Cyclospora cayetanensis.

There are clinical clues that should raise suspicion that a foodborne microbe is causing inflammatory diarrhea. Such symptoms and signs include: Passage of diarrhea with blood or mucus; presence of severe abdominal pain and occurrence of fever. The most likely pathogens in patients with inflammatory diarrhea are Salmonella or Campylobacter.

For More editorials…

Dr KK Aggarwal
Group Editor in Chief

 
  eMedinewS Audio PostCard

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

How to classify food poisoning depending on the
onset of symptoms?

Audio PostCard
 
    Photo Feature (from the HCFI Photo Gallery)

18th MTNL Perfect Health Mela 2011–Divya Jyoti – An Inter Nursing School + College Health Festival

Stage exposure for a nurse is very important to become a good communicator in life. Nusres from various colleges took part in the Skit competitons (Gandhi giri).

 
Dr K K Aggarwal
 
    National News

National Conference on Insight on Medico Legal Issues – For the First time any conference was posted live on Facebook & Twitter

http://blogs.kkaggarwal.com/?p=1134
http://twitter.com/#!/search/medicolegal
https://www.facebook.com/pages/Insight–on–Medicolegal–Issues/247091668637671

11–year–olds suffer anxiety disorders

MUMBAI: Anxiety disorders are as much a reality in children as they are in adults. A recent study conducted by the BMC–run Sion Hospital has revealed that children as young as 11 years could suffer from anxiety disorders for reasons ranging from academics and co–curricular activities to appearance and even separation from parents. The study was conducted on 450 students from Class 5 to Class 10 in a renowned CBSE school, who were both interviewed and clinically examined. The findings showed that 36.7% showed signs of anxiety disorder, which clearly escalated as students climbed grades–those studying in Class 8, 9 and 10 comprised 35.3% of those suffering from the disorder. The statistics indicated that anxiety levels peak in the age group of 13–15 years. (Source: TOI, Nov 3, 2011)

For comments and archives

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

 
    International News

FDA approves device for non–surgical aortic valve repair

The FDA has approved the Sapien Transcatheter Heart Valve for treatment of patients too sick to undergo open heart surgery to repair calcified aortic valves.

For comments and archives

FDA Panel says ezetimibe–simvastatin combination pill okay for some kidney disease patients

An FDA advisory committee has recommended that the ezetimibe–simvastatin combination pill be approved for prevention of cardiovascular disease in chronic kidney disease patients who are not on dialysis.

For Comments and archives

Antibiotics, age add to C. diff risk in hospital

Clostridium difficile infection can have deadly consequences and nearly 6% of hospitalized patients become infected or colonized with the bacteria, a prospective study showed.

For comments and archives

Earthquakes top cause of natural disaster deaths

The death toll in last month’s quake in Turkey stands as testimony to the devastation earthquakes –– responsible for nearly 60% of deaths from natural disasters worldwide –– can cause. The 7.2–magnitude temblor in Turkey killed an estimated 582, adding to the 780,000 quake–related deaths over the past decade. Roughly three times that number likely suffered nonfatal injuries from some of the worst earthquakes on record, Susan A. Bartels, MD, and Michael J. VanRooyen, MD, both of the Harvard Humanitarian Initiative in Boston, reported online in The Lancet. Many of the deaths stemmed from brain or spinal cord trauma, followed by another round of deaths in the first several hours from injuries such as subdural hematomas, liver or spleen lacerations, and pelvic fractures. A third peak in mortality after an earthquake occurred in the days and weeks afterward from sepsis, multisystem organ failure, and disseminated intravascular coagulation from crush injuries. These findings came from review of 123 articles on earthquake–related morbidity and mortality in the medical literature from 1990 to 2010, though many had only anecdotal data.

For comments and archives

 
  Twitter of the Day

@DrKKAggarwal: Watch Padma Shri Awardee Dr KK Aggarwal on Patients with low heart functions s… http://www.youtube.com/watch?v=7mi0j1Ko5ys&feature=share via @youtube

@DeepakChopra: Reversal of Aging Part 8 Higher Consciousness http://bit.ly/rO6pld

 
    Spiritual Update

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

Why Annakoot and Chhath Puja after Diwali

Annakoot and Chhath Puja are celebrated after Diwali. One of the health benefits of the same can be understood with health implications.

For comments and archives

 
    An Inspirational Story

(Dr GM Singh)

Change Your Thinking

It will take just 37 seconds to read this and change your thinking.

Two men, both seriously ill, occupied the same hospital room. One man was allowed to sit up in his bed for an hour each afternoon to help drain the fluid from his lungs. His bed was next to the room’s only window.

The other man had to spend all his time flat on his back. The men talked for hours on end. They spoke of their wives and families, their homes, their jobs, their involvement in the military service, where they had been on vacation. Every afternoon, when the man in the bed by the window could sit up, he would pass the time by describing to his roommate all the things he could see outside the window.

The man in the other bed began to live for those one hour periods where his world would be broadened and enlivened by all the activity and color of the world outside. The window overlooked a park with a lovely lake. Ducks and swans played on the water while children sailed their model boats. Young lovers walked arm in arm amidst flowers of every color and a fine view of the city skyline could be seen in the distance.

As the man by the window described all this in exquisite details, the man on the other side of the room would close his eyes and imagine this picturesque scene. One warm afternoon, the man by the window described a parade passing by. Although the other man could not hear the band – he could see it in his mind’s eye as the gentleman by the window portrayed it with descriptive words. Days, weeks and months passed.

One morning, the day nurse arrived to bring water for their baths only to find the lifeless body of the man by the window, who had died peacefully in his sleep. She was saddened and called the hospital attendants to take the body away.

As soon as it seemed appropriate, the other man asked if he could be moved next to the window. The nurse was happy to make the switch, and after making sure he was comfortable, she left him alone. Slowly, painfully, he propped himself up on one elbow to take his first look at the real world outside. He strained to slowly turn to look out the window besides the bed. It faced a blank wall.

The man asked the nurse what could have compelled his deceased roommate who had described such wonderful things outside this window. The nurse responded that the man was blind and could not even see the wall.

She said, ‘Perhaps he just wanted to encourage you.’

Epilogue: There is tremendous happiness in making others happy, despite our own situations. Shared grief is half the sorrow, but happiness when shared, is doubled. If you want to feel rich, just count all the things you have that money can’t buy.

‘Today is a gift, that is why it is called The Present.’

For comments and archives

 
  Fitness Update

(Contributed by Rajat Bhatnagar, International Sports & Fitness Distribution, LLC, http://www.isfdistribution.com)

12 Indian foods that cut fat

Mustard oil

Mustard oil has low saturated fat compared to other cooking oils. It has fatty acid, oleic acid, erucic acid and linoleic acid. It contains antioxidants, essential vitamins and reduces cholesterol, which is good for the heart.

For comments and archives

 
    Healthy Driving

(Conceptualized by Heart Care Foundation of India and Supported by Transport Department; Govt. of NCT of Delhi)

Cellular Phone and Driving

When using your cellular phone while driving, always remember your number one responsibility is driving. Talking on a mobile phone, while driving, is an offence in India.

For comments and archives

 
    Medicine Update

(Dr. Neelam Mohan, Director Pediatric Gastroenterology, Hepatology and Liver Transplantation, Medanta – The Medicity)

Medical management of neonatal cholestasis

Central acting drugs

  • Ondansetron (<12 years) 2–4mg twice–daily
  • Naltriaxone 6 –20 mg/day
  • Termaprazine
  • Terfenadine 1–3mg/kg/day
  • Carbamazepine

For comments and archives

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    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Hypercalcemia

  • Conditions causing hypercalcemia: Malignant neoplasms (with or without bone involvement), primary and tertiary hyperparathyroidism, sarcoidosis, vitamin D intoxication, milk–alkali syndrome, Paget’s disease of bone (with immobilization), thyrotoxicosis, acromegaly, and diuretic phase of renal acute tubular necrosis.
  • For a given total calcium level, acidosis increases the physiologically active ionized form of calcium.
  • Prolonged tourniquet pressure during venipuncture may spuriously increase total calcium.

For Comments and archives

 
    IJCP Special

Dr Good Dr Bad

Situation: A pregnant dead lady needed immediate LSCS to deliver the baby.
Dr Bad: Make a horizontal incision.
Dr Good: Make a vertical incision.
Lesson: Use a vertical skin incision to provide fast entry, adequate uterine exposure, and access to the diaphragm, which may be useful for further resuscitative interventions.

For comments and archives

Make Sure

Situation: A patient with UTI developed kidney failure.
Reaction: Oh my God! Why were long–term antibiotics not considered?
Lesson: Make sure antibiotics are continued in a patient with UTI till three urine cultures are negative.

For comments and archives

 
  Quote of the Day

(Dr GM Singh)

One can never speak enough of the virtues, the dangers, the power of shared laughter.

 
    Mind Teaser

Read this…………………

A 36–year–old primigravida woman at 8 weeks’ gestation comes to the physician for an initial prenatal visit. She is very concerned about this pregnancy because several years ago she aborted a pregnancy in the second trimester because of an unknown chromosomal abnormality discovered on amniocentesis after a routine 18–week ultrasound. An ultrasound report from the previous pregnancy showed:

  • Bilateral shortened femur
  • Thickened nuchal fold
  • Major endocardial cushion defect

She does not know the details from the autopsy performed on the previous fetus, however she was told that the "colored part" of her baby’s eye had dots like the "spokes of a wheel" and that the palms of the hands did not have the normal pattern of creases. Which of the following triple screen patterns is consistent with the patient’s previous pregnancy?

(A) hCG decreased, AFP increased, estriol increased
(B) hCG increased, AFP decreased, estriol increased
(C) hCG increased, AFP decreased, estriol decreased
(D) hCG decreased, AFP decreased, estriol increased
(E) hCG decreased, AFP decreased, estriol decreased

Yesterday’s Mind Teaser: What is not true for HNPCC?

a) It is the most common hereditary colorectal cancer syndrome in USA.
b) It is associated with MMR gene mutation.
c) It is associated with APC mutation.
d) It is associated with carcinoma colon and extraintestinal cancers.

Answer for Yesterday’s Mind Teaser: c) It is associated with APC mutation.

Correct answers received from: Dr Selva Pandian, Dr Alexander Daniel Sunad, Dr Anil Bairaria,
Dr Hitendrasinh Thakor, Dr AK KELA, yogindra vasavada, Dr Chandresh Jardosh, Muthumperumal Thirumalpillai, Dr Jainendra Upadhyay, Dr Krishna Kavita.

Answer for 3rd November Mind Teaser: c) Macrocephaly
Correct answers received from: Dr Valluri Ramarao, Dr Sukla Das, Dinesh Yadav, Dr PC Das,
Dr Shabina Ahmed.

Send your answer to ijcp12@gmail.com

 
    Laugh a While

(Dr GM Singh)

Little Johnny’s Aching Side

At Sunday School they were teaching how God created everything, including human beings. Little Johnny seemed especially interested when they told him how Eve was created out of one of Adam’s ribs.

Later in the week his mother noticed him lying down as though he were ill, and said, "Johnny what is the matter?"

Little Johnny responded, "I have a pain in my side. I think I'm going to have a wife."

 
    Medicolegal Update

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

Police/magistrate is empowered by law in India to order a designated doctor to perform a Forensic autopsy

  • A medicolegal autopsy means an examination of the body after death, which is conducted in cases where the circumstances of the death suggest that the death was caused by homicide, suicide or accident or is suspicious in nature where criminal investigation is instituted.
  • Designated area Police/magistrate is empowered by law in India to request/order the designated doctor to perform a Forensic/medico–legal autopsy, hence no consent from the family/legal heir is required for forensic autopsy.
  • Autopsiacadaverum or an autopsy is the post–mortem examination of corpse by a registered doctor. It is a specialized surgical procedure that consists of a thorough examination of a corpse to determine the identity of corpse, the cause and manner of death and to evaluate any disease or injury that may be present. The autopsy must be performed by a specialized experienced medical doctor; however, if possible it should preferably be done only by forensic medicine qualified/experienced doctor
  • The autopsy ideally includes a thorough external examination of the body and a probing examination of the internal organs of the body. During the external examination, the doctor searches for wounds and injuries, noting deformities, absence of limbs, state of nutrition, and unusual features.
  • The doctor should examine the hands, fingers, fingernails, feet, teeth, scalp, tattoos, scars, hair, skeleton remains, hair fibers, jewelry, and clothing.
  • The doctor conducting the internal examination, the autopsy surgeon should remove the deceased’s chest plate, lungs, heart, liver, intestines, etc. and, with the use of a scalpel, examine these organs for wounds, disease, and deformities.
  • There should be an arrangement to videotape the autopsy and the doctor must release a report detail its findings, including the cause of death to the police as early as possible. It is best and most transparent if postmortem report is handed over along with dead body only
  • Autopsies, as well as the reports released by the medical examiner, vary in quality. Some medical examiners take little care in their work. A small percentage is outright incompetent.
  • Once an autopsy is complete the body must be well reconstituted by sewing/suturing it back together with cosmetic care of deceased body. Suture from chin to pubic prominence should be masked by resembling skin color paste.

For comments and archives

 
    Public Forum

(Press Release for use by the newspapers)

Get your Press release online http://hcfi.emedinews.in (English/Hindi/Audio/Video/Photo)

X–ray can be normal in Pneumonia

A chest X–ray can be normal in the first 24 hours of pneumonia, said Padma Shri & Dr. B C Roy National Awardee, Dr. KK Aggarwal, President, Heart Care Foundation of India.

Pneumonia can be community–acquired or hospital–acquired. Community–acquired pneumonia is pneumonia that is acquired in the community in a person without a history of contact with a patient or a health care worker and can be treated by simple antibiotics.

But if a person develops pneumonia in 48 hours after getting admitted to hospital or after 48 hours of endotracheal intubation it is called hospital-acquired pneumonia. This pneumonia needs treatment with combination of costly antibiotics.

HCAP is healthcare–associated pneumonia that occurs in a non hospitalized patient but with extensive healthcare contact. Public must avoid visits to the hospitals to avoid this as once the pneumonia develops, it requires costly and aggressive antibiotics.

One should suspect HCAP if the patient in the last one month has received any intravenous therapy; has been going to a doctor for a wound care; has received intravenous chemotherapy; has visited a hospital setting or a hemodialysis clinic. It should also be suspected if the person was admitted to a hospital with acute care facilities in the last 3 months.

Uncomplicated community–acquired pneumonia (CAP) can be treated in a clinic as it has low mortality but patients with CAP who require admission have 37% mortality.

High–risk community-acquired pneumonia patients can be remembered by the formula CURB 65

  • C stands for confusion (anoxia)
  • U stands for Urea more than 20 (pre renal azotemia)
  • R stands for respiratory rate more than 30 per minute (due to low oxygen)
  • B stands for low blood pressure systolic less than 90 and diastolic less than 60 (due to CO2 retention)

Any patient of community–acquired pneumonia who does not respond within 72 hours should be treated as high–risk patient. Pneumonia patients have low mortality if they have received pneumonia/flu vaccination in the past.

In case of community–acquired pneumonia, one can treat only on the basis of clinical features and a chest X–ray. But in healthcare–associated pneumonia, sputum culture examination is required. Do not treat X–ray, breathlessness or cough as they may persist for a long period of time after treatment.

Cough in pneumonia may last for a week and X–ray may take four weeks to clear in normal individuals and 12 weeks in the elderly.

Repeat X–ray after one week of discharge is not necessary. However follow up X–ray is required at 8 to 12 weeks to document resolution of pneumonia and to exclude underlying malignancy.

For simple healthcare–associated pneumonia where multidrug resistance is not suspected: Treat with IV 2 g of ceftriaxone or Levofloxacin 750 mg daily or ampicillin–sulbactam 3 g intravenous every six hours. The best bet is to give 750 mg Levofloxacin every day.

For comments and archives

 
    Readers Response
  1. Thank You very much for the latest medical informations. Regards: Alex Franklin
 
    Forthcoming Events

CSI 2011

63rd Annual Conference of the Cardiological Society of India

Date: December 8–11, 2011.
Venue: NCPA Complex, Nariman Point, Mumbai 400021

Organizing Committee

B. K. Goyal – Patron
Samuel Mathew – President CSI
Ashok Seth – President Elect & Chairman Scientific Committee
Lekha Adik Pathak – Chairperson
Satish Vaidya & C. V. Vanjani – Vice Chairman
N. O. Bansal – Organizing Secretary
B. R. Bansode – Treasurer
Ajit Desai , Ajay Mahajan , G. P. Ratnaparkhi – Jt. Org. Secretaries
Shantanu Deshpande , Sushil Kumbhat , Haresh Mehta – Asst. Org. Secretaries
D. B. Pahlajani, A. B. Mehta , M. J. Gandhi , G. S. Sainani, Sushil Munsi, GB Parulkar, KR Shetty – Advisory Committee

Contact: Dr. Lekha Adik Pathak, Chairperson, CSI 2011; Dr. Narender O. Bansal, Org. Secretary, CSI 2011 Tel: 91 – 22 – 2649 0261/2649 4946, Fax: 91 – 22 – 2640 5920/2649 4946.
Email: csi2011@ymail.com, csimumbai2011@gmail.com Website: www.csi2011mumbai.com

eMedinewS Events: Register at emedinews@gmail.com

3rd eMedinewS Revisiting 2011

The 3rd eMedinewS – revisiting 2011 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 22nd 2012.

The one–day conference will revisit and cover all the new advances in the year 2011. There will also be a webcast of the event. An eminent faculty is being invited to speak.

There will be no registration fee. Delegate bags, gifts, certificates, breakfast, lunch will be provided. The event will end with a live cultural evening, Doctor of the Year award, cocktails and dinner. Kindly register at www.emedinews.in

3rd eMedinewS Doctor of the Year Award

Dear Colleague, The Third eMedinews "Doctor of the Year Award" function will be held on 22nd January, 2012 at Maulana Azad Medical College at 5 pm. It will be a part of the entertainment programme being organized at the venue. If you have any medical doctor who you feel has made significance achievement in the year 2011, send his/her biodata: 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

  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