emedinews
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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

 
  Editorial …

6th January, 2011, Thursday                                eMedinewS Presents Audio News of the Day

2nd eMedinewS – revisiting 2010 at http://www.docconnect.com on 9th January 2011

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

Harvard Top 10 Health Stories of 2010 (Part I) (Harvard Health Letter)

  1. Health care reform: The health care reform legislation was signed into law by President Barack Obama on March 23, 2010.
  2. Smartphones, medical apps, and remote monitoring: Smartphones and tablet computers are making it easier to get health care information, advice, and reminders on an anywhere–and–anytime basis. Provide useful information (calorie counters, first aid and CPR instructions) or perform calculations.
  3. New CPR guidelines: The American Heart Association issued new guidelines for cardiopulmonary resuscitation (CPR) this year that continue the trend toward simplifying CPR and emphasizing chest compressions. For trained rescuers, the guidelines change the CPR sequence from airway, breathing, and chest compressions and the A–B–C mnemonic to putting chest compressions first, followed by checks of the airway and breathing, or C–A–B. People who haven’t had CPR training are encouraged to do only chest compressions because they are easier and "more readily guided by dispatchers over the telephone." The compressions should be fast (about 100 times a minute) and hard (so that the chest goes down by two inches or more). Fewer than half of those who suffer cardiac arrest receive CPR, so the hope is that more people will give CPR—and do so quickly— if it’s simpler and doesn’t involve mouth–to–mouth breathing. The guidelines note that the results for chest compression–only CPR are similar to those for traditional CPR for adults in cardiac arrest outside of the hospital. But conventional CPR is still better for children because cardiac arrest in children is usually preceded by a lack of breathing, so the mouth–to–mouth breaths are needed to restore oxygen levels in the blood. Research results reported this year in The Lancet, Journal of the American Medical Association, and The New England Journal of Medicine all suggested that in most cardiac arrest cases, chest compression–only CPR is as effective, if not more so, than conventional CPR.
  4. Making stem cells: Heart attacks, strokes, and many other conditions destroy cells, and for years, scientists believed that it was impossible to make replacements. Then, four years ago, a Japanese researcher, Shinya Yamanaka, discovered a technique for reprogramming cells back into stem cells, so that they would function like a biological blank slate and be capable of turning into any other type of cell. Dr. Yamanka called his creations induced pluripotent stem cells, and a whole new frontier of stem cell research opened up. Scientists have since figured out ways to turn one cell type directly into another type: blood vessel cells have been turned into bone and fat cells, and skin cells have been turned into blood cells. And this year, stem cell research took another leap forward when a Harvard researcher, Derrick Rossi, reported results demonstrating a technique that may make the creation of induced pluripotent stem cells a lot easier and safer. Rossi and his colleagues at the Harvard Stem Cell Institute reprogrammed adult skin cells with synthetic messenger RNA that leaves DNA intact, instead of inserting genes into DNA. Research with embryonic stem cells remains important, and in October 2010, Geron, a California biotech company, began enrolling people in a trial to test the safety of using cells derived from embryonic stem cells to treat spinal cord injuries. But researchers are also making some remarkable progress toward turning readily available cells, such as skin or blood cells, into other types of cells. These new cells would be genetically identical to other cells in the body and therefore shouldn’t be rejected by the immune system when they’re transplanted to replace cells lost to disease.
  5. Heightened awareness of concussions: Concern about sports–related concussions, especially in football, has been growing as evidence has increased that repeated concussions can cause permanent brain damage over the long term, even if the short–term effects are fairly mild (most concussions do not result in a loss of consciousness, for example) and CT and MRI scans are normal. Some researchers are calling concussion–related brain damage chronic traumatic encephalopathy (encephalopathy is a catchall term for any degenerative disease of the brain). There were several efforts in 2010 to reduce the number and severity of concussions. The National Football League started to fine players for illegal hits this season. The American Academy of Neurology came out with a position paper that says any athlete who might have suffered a concussion shouldn’t be allowed to partcipate again until he or she has been evaluated by a doctor with training in the evalulation and management of sports concussions. The American Academy of Pediatrics released a report about sports–related concussions in children and adolescents that says younger people often need more time (7 to 10 days or even longer) to recover from a concussion than college or professional athletes. Several states have passed laws requiring high schools to have concussion management programs. The concussion risk is greatest for football players, but girl basketball and soccer players also have relatively high rates. Meanwhile, research into concussions continues. Boston University researchers who have been prominent in the field caused a stir with a finding that linked concussions and chronic traumatic encephalopathy to amyotrophic lateral sclerosis (Lou Gherig’s disease).
Dr KK Aggarwal
Editor in Chief
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    Live Web Cast from DocConnect.com
DocConnect.com
 
  eMedinewS Audio PostCard

  MEDICON 2010, 26 December
  53rd Annual Delhi State Medical Conference
Dr Ganesh K Mani on indications of CABG in era of Drug-eluting stents

Audio PostCard
 
  SMS of the Day

(By Dr GM Singh)

"Life is the first gift, love is the second, and understanding the third."

Marge Piercy

 
    Photo Feature (from the HCFI Photo Gallery)

2nd eMedinews revisiting 2010

2nd annual eMedinews revisiting 2010, a day long conference will be organized on Sunday, 9th January, 2011, at Maulana Azad Medical College, New Delhi. This was announced at a press conference by Dr Padma Shri & Dr BC Roy National Awardee KK Aggarwal, President of the Conference. The conference, 8 am to 8 pm, will cover all the new happenings of the year 2010 of importance to the public and general practitioners.

 
Dr K K Aggarwal
 
    National News

Certificate courses in 2D and 3D Echocardiography/Fellowship Diploma in non invasive cardiology

Contact Dr KK Aggarwal, Moolchand Medcity, email: emedinews@gmail.com

eMedinewS Revisiting 2010 to have a live webcast

eMedinewS Revisiting 2010 will have a live webcast on www.docconnect.com on 9th January, 2010. Those who will not be able to attend the conference can watch the proceedings live on the website. The webcast was a great success last year. The conference will have eminent speakers. Look out for the program details in the forthcoming editions of eMedinewS. We expect 1000 doctors to attend conference live and 1000 doctors to see it through the website.

Health Ministry declares common entrance test notifications "invalid"

NEW DELHI: Taken aback by the Medical Council of India’s notifications for holding common entrance tests to graduate and post graduate medical courses, Union Health and Family Welfare Ministry on Monday declared the two notifications as "invalid" and directed the MCI to withdraw these with immediate effect. The Ministry, in a letter to S.K. Sarin, chairman of the Board of Governors of the MCI, said the notifications were issued without the prior approval of the Health and Family Welfare Ministry as required under Section 33 of the Indian Medical Council Act, 2010. The notifications were issued ahead of a meeting of State Health Ministers and secretaries, which was to discuss the matter for arriving at a consensus before taking the final call on the issue. The meeting, to be chaired by the Union Health and Family Welfare Minister Ghulam Nabi Azad, was to take on board all shades of opinions on the matter of National Eligibility–cum–Entrance Test (NEET) for MBBS course. However, no discussion on a common entrance test for PG courses was on the agenda for the meeting scheduled from January 11 to 13 that would also taken up the introduction of Bachelor in Rural Health Care course, among other things. (Source: The Hindu, Jan 4, 2011)

 
    International News

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

New vitamin D guidelines still fall short, says experts

Emerging clinical research over the last decade has sparked enormous interest in the "sunshine vitamin" because of new associations with bone density, a stronger immune system, a healthier heart and brain, and maintenance of cell integrity. The hormone–like vitamin is noted to have direct effects on cells throughout the body and act on more than 2,000 genes. For this reason, the Institute of Medicine, of the National Academy of Sciences, was asked by the United States and Canadian governments to assess current data and subsequently tasked a committee of experts to update nutrient reference values. The IOM committee did as asked and has now tripled the recommended dietary allowances (RDAs) for vitamin D in ages 9 to 50 to (600 IU) and raised amounts even further for those ages 70 and older (800 IU). Also, it doubled the upper level (UL) intake for vitamin D (4000 IU). However, the new guidelines for vitamin D came as a disappointment to key vitamin D researchers who consider the report too conservative to deal with a widespread epidemic.

The influence of sun exposure in itself, which causes the skin to generate the equivalent of a whopping 20,000 IU to 40,000 IU of vitamin D within only a few minutes depending on season and time of day, has now been highly regarded as having had a profound and crucial role in preserving health, beyond the needs to regulate absorption of calcium.

(Dr Monica and Brahm Vasudev)

New recommendations on Bone Densitometry in Children and Adolescents released

New recommendations on Bone Densitometry regarding the use, interpretation, harms, and costs in Children and Adolescents have been released by the American Academy of Pediatrics (AAP) and reported online December 27, 2010, in the journal Pediatrics.

Three markers predict significant bleeding from stable pelvic fracture

According to researchers at the Massachusetts General Hospital, hree clues may predict significant Bleeding From stable pelvic fracture: a hematocrit of =30% at the time of hospital admission, a pelvic hematoma on a CT scan, and systolic blood pressure of =90mm Hg. The study is published online December 20 in Archives of Surgery.

Guideline for tonsillectomy in children

Clinical Practice Guideline for Tonsillectomy in Children have been published online January 3, 2011, in the journal Otolaryngology–Head and Neck Surgery. The new guideline provides evidence–based recommendations to select children who are the best candidates for tonsillectomy, including preoperative, intraoperative, and postoperative care and management. The guideline also emphasizes the need for evaluation and intervention in special populations, improving counseling and education for families, describes management options for patients with modifying factors, cutting down on inappropriate or unnecessary variations in care, and also covers the major public health implications of tonsillectomy.

Depression plus diabetes increases death from heart disease

According to a study in the January Archives of General Psychiatry, comorbid diabetes and depression increases the chances of death, especially due to heart disease, in middle aged women. In the study, the relative risk for all–cause mortality among a large cohort of women who had both conditions was 3.11 (95% CI 2.70 to 3.58) compared with women who had neither disease condition.

 
    Infertility Update

Dr. Kaberi Banerjee, Director Precious Baby Foundation

What are the complementary and alternative treatments of infertility?

Acupuncture

In a German study published in 2002, acupuncture performed 25 minutes before and after IVF embryo transfer increased IVF pregnancy rates. In a similar study conducted by The University of South Australia in 2006, the acupuncture group’s odds (although not statistically significant) were 1.5 higher than the control group. Although definitive results of the effects of acupuncture on embryo transfer remain a topic of discussion, study authors state that it appears to be a safe adjunct to IVF.

For queries contact: banerjee.kaberi@gmail.com

 
    Hepatology Update

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

Zinc supplementation and pneumonia

Zinc is an essential element for growth and development of children. Its deficiency is associated with increased risk of infection, particularly diarrhoea and pneumonia. Zinc supplementation in children has been reported to prevent pneumonia; however, its effect remains unclear. In a metanalysis published in the Cochrane database on the role of zinc supplementation in the prevention of pneumonia in children of two to 59 months of age on the basis of six randomised controlled trials conducted in Bangladesh, India, Peru, and South Africa. Children of two to 59 months of age were randomly assigned to receive zinc or a placebo. In two studies, the children were given vitamin A in both the groups. Analysis of the studies showed that zinc supplementation was significantly associated with reducing the incidence and prevalence of pneumonia among children of two to 59 months of age. Evidence provided so far from randomised controlled trials is sufficient to recommend zinc intake in deficient populations through supplementation, dietary improvements, or fortification, for enhancing child survival.

 
    Medicolegal Update

Dr Sudhir Gupta, Asso Professor, Forensic Medicine & Toxicology, AIIMS

What is the concept of Brain stem death?

Medullary neurons are most resistant to anoxia; if they are dead, then higher centers are also dead

There are three distinct schools of thought to diagnose death: (i) French school that is similar to Harvard (ii) English school that is similar to Harvard (iii) Austor–German school that includes Harvard criteria and bilateral serial angiography of internal carotid and vertebral arty criteria. A negative angiogram for more than 15 minutes proves death.(iv) Absence of brainstem reflexes: (a) dilated and fixed pupil (b) absent corneal reflexes (c) absent Doll’s head phenomenon (d) absent cilospinal reflexes (e) absent gag reflex (f) absent vestibular response to caloric stimulation (g) absent tonic neck reflex (v) EEG not mandatory (vi) Spinal reflex not important (vii) All the findings above remain unchanged for at least 12 hours. Brainstem death can be pronounced only if the pathological processes responsible for above are deemed irreparable with presently available means.

The basic teaching of the American school was not the brain, but the brainstem death, after which there is the point of no return that should be equated as death. There were several reasons for this equation:

  • Medullary neurons are most resistant to anoxia, if they are dead then higher centers are also dead
  • Brainstem is responsible for the vital functions because it is the seat of respiratory and circulatory center
  • Brainstem is necessary for proper functioning of the cortex as all sensory and motor nerves pass through this gateway.
  • Immediately after an individual is put on respirator and other life support systems, a systemic examination is done to exclude the possibility of brainstem death. If Minnesota criteria are fulfilled, life support systems should be withdrawn and the person is to be declared dead.

(Reference Dr. PC Dikshit Head (MAMC) MD LLB, Textbook of forensic medicine, Peepe Publisher)

 
    Women’s Health: Preventing Top 10 Threats (Mayo Clinic)

COPD

Chronic obstructive pulmonary disease is a group of chronic lung conditions, including bronchitis and emphysema. To prevent COPD:

  • Don’t smoke. Avoid exposure to secondhand smoke.
  • Minimize exposure to chemicals and air pollution.
 
    Legal Question of the Day

(Contributed by Dr MC Gupta, Advocate)

Q. What should a doctor do when:

  • A victim of sexual assault/rape victim voluntarily comes for treatment to the hospital after the incidence but she (or her guardian) does not want that the matter may be reported to the police?
  • A child is brought for treatment by the mother and the doctor suspects that it is a victim of sexual abuse by a near relative but the mother does not want to report the matter to the police?

What is the applicability of section 39, CrPC, section 174, CrPC and section 202, IPC in such cases?

A.

•  When anybody comes to know that a crime has been committed, it is part     of his responsibility and duty toward the public that he should report the     same to the appropriate authorities.
•  A doctor has to deal with medico–legal cases. I would classify medico–legal     cases into the following categories:
a. Those cases that are brought to the doctor by the police;
b. Those cases that have to be mandatorily informed to police under Section     39 CrPC;
c. Those cases where the doctor suspects foul play (such as rape; child     abuse; stab wound etc.)
d. Those cases where the injury or death appears to be accidental but is likely     to be a subject of litigation in future (such as a roadside accident).

A sexual offence belongs to the category ‘c’ above. The doctor should ordinarily report such cases to the police but should not do so when the person concerned specifically withholds consent for such reporting and requests professional confidentiality. However, if the doctor has reason to believe that the victim maybe either incompetent to give or withhold free and informed consent (minor; unsound mind; coercion or fear or undue influence), he would be within his rights to act in the best interest of such victim and override the requirement of professional confidentiality and report the matter to the concerned authorities.

•  Some offences have to be mandatorily reported to the authorities as per     the provisions of Section 39 of the Code of Criminal Procedure, 1973, titled     "Public to give information of certain Offences". The section is reproduced     below:

"(1) Every person, aware of the Commission of, or of the intention of any other person to commit any offence punishable under any of the following sections of the Indian Penal Code ( 45 of 1860 ), namely:

××××××
××××××××
××××××××

shall, in the absence of any reasonable excuse, the burden of proving which excuse shall lie upon the person so aware, forthwith give information to the nearest Magistrate or Police officer of such Commission or Intention."

•  Section 174 of Cr.P.C., titled "Police to inquire and report on suicide etc."     refers only to cases where death has been caused by suicide, animal,     machinery or accident etc.

•  Section 202, IPC, is titled "Intentional omission to give information of     offence by person bound to inform" and reads:

"Whoever, knowing or having reason to believe that an offence has been committed, intentionally omits to give any information respecting that offence which he is legally bound to give, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine, or with both."

It is clear that the words "which he is legally bound to give" refer to section 39, CrPC.

•  The offences of sexual assault mentioned in the question do not fall within     the purview of Section 39 CrPC. Hence there is no mandatory requirement     that a doctor should report the same to the police.

•   The doctor concerned may face the following situations and he/she should     act accordingly as indicated below:

 a. When the patient/victim/guardian has no objection to the crime being      reported to the police: The doctor should inform the police.
 b. When the patient/victim/guardian appears to the doctor to be      competent to give free and informed consent and expressly states (in      writing, under signature, with a witness) that he/she does not want a      police report: The doctor should not inform the police. However, it is likely      that some time in future, the police may ask the doctor about the      particular incident. Hence it is important that the doctor should keep the      record of the patient in sufficient detail in safe custody because it may be      the subject of litigation in future.
 c. When the doctor thinks that it is likely that the victim/guardian is a      minor or not of sound mind or is under influence or fear or is acting      against the interests of the victim––The doctor should feel free to breach      the confidentiality clause and should report the matter to the police.

 
    Medilaw – Medicolegal Judgement

(Dr KK Aggarwal)

Can DMC take action against some one not registered with DMC? (Part I)

HIGH COURT OF DELHI AT NEW DELHI: Subject: Jurisdiction in Disciplinary Issue against a Doctor: C.W.P. NO. 4414 OF 2003: Date of decision: 26.07.2004: DR. YASH NIGAM … PETITIONER vs DELHI MEDICAL COUNCIL RESPONDENT: MR. JUSTICE SANJAY KISHAN KAUL (Oral):

  1. The petitioner is an Orthopaedics Doctor and is aggrieved by the order dated 23.06.2003 passed by the DMC, the respondent herein whereby the petitioner has been debarred from medical practice for a period of six weeks from the date of the said order.
  2. The matter raised in issue is the jurisdiction of the respondent to proceed against the petitioner since it is the contention of the petitioner that he not being registered with DMC, the respondent Council has no jurisdiction to proceed on disciplinary issue against the petitioner. MCI was not made a party to the present petition, but this petition was heard along with WP (C) No. 5089/2003, which has also been filed by the petitioner herein in which MCI is impleaded as respondent No. 2. Thus, submissions were heard on behalf of MCI by Mr. Maninder Singh even in the present matter.
  3. The undisputed facts are that the petitioner herein passed as M.S. Orthopaedics from S.N. Medical College, Agra, Ph.D. from Central Research Institute of Traumatology and Orthopaedics Moscow (Russia). The petitioner is registered with MCI as registered practitioner.
  4. One Mrs. PS who was operated on by the petitioner in respect of knee joint problem on 10.04.2001, made a complaint against the petitioner. It is this complaint which has given rise to the impugned order.
  5. In order to appreciate the contours of the controversy, it would be necessary to consider provisions of the IMC act 1956 and DMC 1997. The provisions of Section 15(1) of IMC Act require a person holding adequate medical qualifications as per schedule of the Act to enroll himself on any State Medical Register. Section 21 of IMC Act refers to the Indian Medical Register, which is to contain names of the persons who are for the time being enrolled on any State Medical Register and who possess the recognised medical qualifications. Section 22 requires copies of the State Medical Registers to be sent to the MCI for facilitating entry into the Indian Medical Register. Section 24 empowers the MCI to remove the name of a person from the Indian Medical Register. The petitioner herein registered with MCI in the year 1986.
  6. The problem has arisen not only in this matter but in other matters giving rise to various disputes on account of the fact that all the States of the country have not provided for a State Act. Insofar as Delhi is concerned, the Act came into being only in the year 1997 and was notified and published in the Gazette on 22.08.1997.
  7. The DMC Act refers to two terminologies in respect of the doctors, which are ‘medical practitioner’ or ‘practitioner’ and ‘registered medical practitioner’. These two terms are defined in the provisions of Sections 2(7) and 2(14) of the DMC Act. The same are as under:–
    "2. Definitions.–

    (7) ‘Medical practitioner’ or ‘practitioner’ means a person who is engaged in the practice of modern scientific system of medicine and all its branches and has qualifications as prescribed in the First, Second or Third Schedule to the Indian Medical Council Act, 1956 (102 of 1956);

    (14) ‘registered practitioner’ means a medical practitioner having registerable qualification as prescribed in the Indian Medical Council Act, 1956 (102 of 1956) whose name is, for the time being, entered in the register, but does not include a person whose name is provisionally entered in the register;"
  8. The definition of ‘register’ is given under Section 2(13) of the DMC Act, which is as under:–

    "2.(13) ‘register’ means the register of medical practitioners prepared or deemed to be prepared and maintained under this Act;"
  9. A reading of the aforesaid provisions would show that for a doctor to be a registered practitioner within the meaning of DMC Act, his name has to be entered in the register of the medical practitioners maintained under the said Act.
  10. Section 10 of DMC Act provides for powers, duties and functions of the Council. Sub–section (a) of Section 10 requires the Council to maintain a register for registration of medical practitioners. This would imply that once a medical practitioner is entered on the register, he becomes a registered practitioner. Sub–sections (e) and (f) of Section 10 authorizes the Council to exercise such powers and perform duties as are laid down in DMC Act and to receive complaint from the public against misconduct or negligence by a medical practitioner. This would imply that the complaint can be received by DMC not only in respect of a registered practitioner, but in respect of even a medical practitioner.
  11. Section 15 of DMC Act refers to preparation and maintenance of a register of medical practitioners. It is Section 21 of DMC Act which gives power to DMC for disciplinary action including removal of name from the register. The relevant provision is sub–section (2) of Section 21, which is as under:–

    "21. Disciplinary action including removal of names from the register.-

    (2) If a registered practitioner has been, after due inquiry held by the Council or by the Executive Committee in the prescribed manner, found guilty of any misconduct by the Council or the Executive Committee, the Council may–

      (a) issue a letter of warning to such practitioner; or
      (b) direct the name of such practitioner–
      (i) to be removed from the register for such period as may be specified       in the aforesaid direction; or
      (ii) to be removed from the register permanent

    Explanation.– For the purpose of this section a registered practitioner shall be deemed to be guilty of misconduct if –

      (a) he is convicted by a criminal court for an offence which involves moral turpitude and which is cognizable within the meaning of the Code of Criminal Procedure, 1974 (2 of 1974), or

      (b) in the opinion of the Council his conduct is infamous in relation to the medical profession particularly, under any Code of Ethics prescribed by the Council or by the Medical Council of India constituted under the Indian Medical Council Act, 1956 (102 of 1956) in this behalf." A reading of this provision would, thus, show that the Council has an authority to proceed only against a registered practitioner. The question of the deletion of his name would only arise if his name is on the State Register.
  12. A reading of the aforesaid provisions, in my considered view, leaves no manner of doubt that what is envisaged is that first the name of a medical practitioner has to be entered into the State Register where after he becomes a registered practitioner and the doctor becomes subject to the jurisdiction of DMC only on being so registered.
 
    Ethical earning

What is reimbursable to a doctor?

One can charge for medical residents care

 
    Lab Update

(Dr Arpan Gandhi and Dr Navin Dang)

Serum gastrin

  • To detect an overproduction of gastrin
  • To help diagnose Zollinger–Ellison syndrome
  • To monitor for recurrence of a gastrin–producing tumor (gastrinoma)
 
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    Medi Finance Update

Q. What will be the consequence for non–compliance of provisions of Income Tax Act?

Ans. Doctor will be liable to penalties. But if he gives reasonable cause for the default made, then he may not be liable to penalties.

 
    Drug Update

List of Approved drugs from 01.01.2010 TO 30.4.2010

Drug Name
Indication
DCI Approval Date
Olopatadine 5mg + Ambroxol 30mg tablets
For the management of cough in adult patients only
5/3/2010
 
    IMSA Update

International Medical Science Academy (IMSA) Update

Diabetic foot infection

Results of the French OPIDIA study, a prospective study, found that in spite of being managed at specialized centres that were, in general, following the agreed–upon published guidelines, the prognosis for diabetic foot infection remains poor, with a high rate (48%) of lower–limb amputation.

(Ref: Richard JL, et al. Management of patients hospitalized for diabetic foot infection: Results of the French OPIDIA study. Diabetes Metab. 2010 Dec 17. Epub ahead of print)

 
    IJCP Special

Dr Good Dr Bad

Situation: A patient with skin diseases needed circumcision and wanted to know whether mediclaim covers it or not.
Dr. Bad: It will not be covered.
Dr. Good: It will be covered.
Lesson: Circumcision is excluded unless it is necessary for treatment of a disease.

Make Sure

Situation: A terminally ill patient who developed bed sores is prescribed only systemic antibiotics.
Reaction: Please change the position of the patient frequently and keep the skin clean and dry.
Lesson: Make sure that good nursing care and maintenance of skin hygiene is advised first to patients with bed sores, along with topical antibiotics.

 
    Lighter Side of Reading

An Inspirational Story
(Contributed by Dr Prachi Garg)

The value of sincerity of purpose

A story is told of a man who approached three workers who were doing the same job. "What are you doing?" he asked each one of them separately andgot different answers. "I am cutting the stones" replied the first. "I am earning my livehood" replied the second. "I am building a mosque" replied the third. Each of the three workers saw himself linked to a different purpose each, one was to that extent, different from others, although all worked alike and were engaged in the same task.

Our two hands with which we work are in no sense different from the hands of any other person.

The value of what we do depends upon the quality of the inner purpose in our heart with which we do our work.

………………………………

Mind Teaser

Read this…………………

What two words, when combined, hold the most letters?

Yesterday’s Mind Teaser: OturnedUT
Answer for Yesterday’s Mind Teaser:
Turned inside out

Correct answers received from: Dr S Upadhyaya, Dr T. Samraj, Dr Apurva Koirala, Dr Jayashree, Dr Bitan Sen, Dr Sudipto Samaddar, Dr K Raju, Dr Rajiv Dhir, Dr Chandresh Jardosh, Dr Kumaravel S, Dr Muthumperumal Thirumalpillai, Dr Anupam Sethi Malhotra, Dr Neelam Nath, Dr K V Sarma, Dr Manjesha

Answer for 4th January Mind Teaser: Three blind mice (they have no "i"s)
Correct answers received from: Dr Sudipto Samaddar, Dr Anurag Jain, Dr Rashmi Chhibber, Dr Satish Gunawant

Send your answer to ijcp12@gmail.com

………………………………

Laugh a While
(Contributed by Dr GM Singh)

This older man was on the operating table awaiting surgery and he insisted that his son, a renowed surgeon, perform the operation as he was about to receive the anesthesia he asked to speak to his son. "Yes dad, what is it?"

"Don’t be nervous, son. do your best and just remember, if it doesn’t go well. if something happens to me, your mother is going to come and live with you and your wife."

 
    Readers Responses
  1. To the editor, we at Suneera Charitable Centre, GK–1, New Delhi wish to thank the team of emedinews for making us netsavvy at an age people are taking retirements. Everyday before regular newspapers arrive, we read emedinews, inspiration stories, and above all feel happy if the quiz answer sent the previous day was correct. Docconnect will help us to attend medical conference at our place. Please accept our good wishes for the success of conference on 9.1.11. Neelam Nath, Suneera Charitable Centre for Women’s Health, R–265, Greater Kailash–1, New Delhi.
 
    Public Forum

(Press Release for use by the newspapers)

eMedinews revisiting 2010

2nd annual eMedinews revisiting 2010, a day long conference will be organized on Sunday, 9th January, 2011, at Maulana Azad Medical College and will be attended by over 2000 doctors. The conference, 8 am to 8 pm, will cover all the new happenings of the year 2010 of importance to the public and general practitioners. The focus of will be on those advances which have changed the medical practice over the last one year. The conference will be followed by ‘Doctor of the Year’ Awards and a cultural evening.

Addressing a press conference here Dr KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee, President of the Conference said that the conference will have a live webcast on www.docconnect.com and the conference proceedings will also be available on www.emedinews.in for the next one year.

Dr. Aggarwal said that eMedinewS is a daily electronic medical newspaper being emailed to more than 50000 doctors every day. Dr. Aggarwal launched a new electronic audio component to eMedinewS this year and said that now people can listen to audio medical news everyday.

Co–addressing the conference, Dr. Neelam Mohan, Pediatric Hepatologist; Dr. Kaberi Banerjee, IVF Specialist; Dr. N.K. Bhatia, Transfusion Specialist; Dr. Ajay Kriplani, Obesity Surgery Specialist; Dr. Vinod Sanghi, Cardiologist; Dr. Awdhesh Pandey, Nuclear Specialist and Dr. Jamal Khan Stem Cell Specialist released the top findings of the year 2010:

  1. High sensitivity cardiac troponin T test done in healthy people now can detect future chances of heart attack and heart failure.
  2. Botulinum toxin can now be used for watering eyes.
  3. Mammography should continue to be done between 40–50 years of age for early detection of breast cancer
  4. Those who are taking calcium should not take it without vitamin D. Simple calcium can increase chances of heart attack.
  5. One should not take quinine for cramps.
  6. Now a test is available which can diagnose TB in two hours.
  7. NDM1 is the new bacteria which is not sensitive to any antibiotic.
  8. H1N1 is no more an epidemic
  9. In 2011 – Chikungunya may come back again.
  10. Dengue in 2010 had more intestinal symptoms and low platelet counts.
  11. For diabetes, one can use a new test A1C for diagnosis. No fasting is required.
  12. New pill for HIV prevention. A combination pill of tenofovir and emtricitabine reduced the risk of HIV/AIDS by 45% which is to be taken before the exposure.
  13. Dapoxetine is a new SOS drug for premature ejaculation.
  14. For CPR, mouth–to–mouth resuscitation is no more required. Only chest compression is sufficient.
  15. Stem cells in India have now become a reality.
  16. Give pneumonia vaccine to all smokers.
  17. Do CT scans in all chain smokers to detect early lung cancer.
  18. Do not take bisphosphanate (osteporosis drug) continuously. Give drug holidays.
  19. Propoxyphene (pain killer), sibutramine (obesity drug) have been withdrawn.
  20. When PSA (prostate blood test) value is between 2.5 to 4, 25% may have prostate cancer. Further screening is required.
  21. Tramadol pain killer should not be given to those with mental problems or suicidal tendencies.
  22. In paralysis, give a clot–dissolving medicine within 4.5 hours of stroke.
  23. Eight out of 10 risk factors for paralysis are preventable.
  24. Obesity is the new epidemic of the society.

The experts said that the conference will have no entry fees. Public guidelines will be issued after the press conference.

 
    Forthcoming Events

eMedinewS Events: Register at emedinews@gmail.com

eMedinewS Revisiting 2010

The 2nd eMedinewS – revisiting 2010 conference will be held at Maulana Azad Medical College, New Delhi on Sunday January 9th 2011.

The one–day conference will revisit and cover all the new advances in the year 2010. There will also be a webcast of the event. The eminent speakers will be Padma Bhushan Dr Naresh Trehan (Cardiac Surgery); Padma Shri Dr KK Aggarwal (Revisiting 2010); Dr Neelam Mohan (Liver Transplant); Dr N K Bhatia (Transfusion Medicine); Dr Ambrish Mithal (Diabetes); Dr Anoop Gupta (Male Infertility); Dr Kaberi Banerjee (Female Infertility) and many more.

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

2nd eMedinewS Doctor of the Year Award

Dear Colleague, The Second eMedinews Doctor of the Year Award function will be held on 9th January, 2011 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 2010, send his/her biodata: Dr. KK Aggarwal, Padma Shri & Dr. B.C. Roy National Awardee.

IMSA Workshop on Rheumatoid Arthritis

Date: Sunday 16th January, 2011; Venue: Moolchand Medicity; Time: 10–12 Noon

Speakers:

  1. Understanding Biologics: Dr Rohini Handa, Former Head Rheumatology, AIIMS
  2. All what a practitioner should know about rheumatoid arthritis: Dr Harvinder S Luthra, Chief of Rheumatology, Mayo Clinic, Rochester USA

No fee. Register emedinews@gmail.com or sms 9899974439

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    Programe Details

eMedinewS revisting 2010, 9th January MAMC Dilli Gate 8AM-8 PM
Also live at www.docconnect.com, www.emedinews.in

TIME SPEAKER TOPIC Moderator Panelist  
8.00 – 8.30 AM Dr K K Aggarwal Revisiting the year 2010 Dr N P Singh Dr A K Kansal Dr D D Arora
8.30 – 9.00 AM Dr Subramanium        
9.00 – 9.30  AM  Dr S C Tewari Acute Kidney Injury Dr Ramesh Hotchandani Dr U C Bansal Dr Savita
9.30 – 9.45 AM Dr Awadhesh Pandey Thyroid Scan Dr Ambrish Mithal Dr Sundeep Khandlwal DR Manisha Kukreja
9.45 – 10.00 AM Dr Jamal A Khan Stem Cell Therapy Dr Vandana Chadha Dr Rajiv Garg Dr Vijay Grover
10.00 – 10.15 AM Central Bank of India Financial Health Mr Anil Wadhwa Mr Pranay Kumar Dr Bimla Kapoor
10.15 – 10.30 AM LIC India  Life Insurance Schemes Mr Arun Kishore Mr Pranay Kumar Dr N K Gupta
10.30 – 11.00 AM          
11.00 – 11.30 AM Dr N K Bhatia Newer Tests in Transfusion Medicine Dr B B Rewari Dr Prachi Garg  
11.30 - 12.00 AM Dr Praveen Chandra What was New in 2010 in Interventional Cardiology Dr M Khalilullah Dr G M Singh  
12.00 – 12.30 AM Dr Naresh Trehan What's was New in Cardiac Surgery in 2010 Dr O P Yadava Dr Sanjay Sood  
12.30 –  1.00 PM Dr Ajay Kriplani Newer Advances in Obesity Surgery Dr B M L Kapoor Dr Satish Mehta  
1.00 – N 1.30 PM Dr Kaberi Banerjee What’s New in IVF Dr Anoop Gupta Dr Archna Virmani Dr Shashi Bala
1.30 – 2.00 PM Dr Anupam Sibal What’s New in Paedatric Gastroenterology Dr Neelam Mohan Dr Pooja Garg  
2.00 – 2.30 PM Dr D M Mahajan Newer Advances in Dermatology Dr J S Pasricha Dr Rajesh Kumar  
2.30 – 3.00 PM Dr Anoop Gupta Male Infertility Dr Ajit Saxena Dr Uday Kakroo  
3.00 – 3.15 PM Dr Sheh Rawat What’s New in Radiation Oncology Dr P K Julka Dr Vishnu Singhal Dr Srikant Sharma
3.15 – 3.30 PM Dr Neelam Mohan Paedatric Liver  Update  Dr A S Soin Dr Sudesh Ratan Dr A K Duggal
3.30 – 3.45 PM Dr Rohini Handa What’s New in Rheumatology   Dr V K Arora  
3.45 – 4.00 PM Dr Ambrish Mithal Newer Treatments in Diabetes Dr H K Chopra Dr Pavan   
4.00 – 4.15 PM Dr Sanjay Chaudhary Whats new in Eye Care Dr A K Grover Dr Dinesh Negi  
4.15 – 4.30 PM Dr Anil Goyal Whats new in urology      
4.30 – 4.45 PM Dr Rajiv Khosla What’s New in Gastroenterology Dr Ajay Kumar Dr Kirti Jain  
4.45 – 5.00 PM Dr Praveen Bhatia e patient relationship      
5.00 – 8.00 PM Doctor of the year award, cultural hangama