May 7  2015, Thursday
editorial
Seven Behaviors Cut Heart Deaths
Dr KK Aggarwal Seven heart–healthy behaviors can reduce the risk of death from cardiovascular disease. In a prospective study, by Enrique Artero, PhD, of the University of South Carolina, and colleagues and published in the journal Mayo Clinic Proceedings, those who met 3–4 of the American Heart Association’s ‘Simple Seven’ heart–health criteria had a 55% lower risk of cardiovascular mortality than those who met no more than two of those practices over 11 years.

Four core behaviors

1. No smoking
2. Normal body mass index
3. Engaging in physical activity
4. Eating healthfully

Three parameters

1. Cholesterol lower than 200 mg/dL
2. Blood pressure lower than 120/80 mm Hg
3. Not having diabetes
IMA,IJCP,HCFI
eMedipics IMA,IJCP,HCFI
IMA wants Central Act to combat violence against doctors and their medical establishments
News
  • Recent studies in animal models and on human cells have shown an effect of sodium chloride (NaCl) on Th17 cells promoting inflammation.
  • Delays in the recognition and treatment of strokes occurring during hospitalization are common, and in-hospital strokes tend to be more severe and have worse outcomes than strokes occurring among those who are not hospitalized, researchers have reported in JAMA Neurology, published online May 4.
  • According to a study in Gastroenterology. 2014;147(4):784-792, monotherapy with non-selective (ns) NSAIDs increased the risk of diagnosis of upper GI bleeding (UGIB) (IRR, 4.3) to a greater extent than monotherapy with COX-2 inhibitors (IRR, 2.9) or low-dose aspirin (IRR, 3.1). Combination therapy generally increased the risk of UGIB; concomitant nsNSAID and corticosteroid therapies increased the IRR to the greatest extent (12.8) and also produced the greatest excess risk (RERI, 5.5). Concomitant use of nsNSAIDs and aldosterone antagonists produced an IRR for UGIB of 11.0 (RERI, 4.5). Excess risk from concomitant use of nsNSAIDs with selective serotonin reuptake inhibitors (SSRIs) was 1.6, whereas that from use of COX-2 inhibitors with SSRIs was 1.9 and that for use of low-dose aspirin with SSRIs was 0.5. Excess risk of concomitant use of nsNSAIDs with anticoagulants was 2.4, of COX-2 inhibitors with anticoagulants was 0.1, and of low-dose aspirin with anticoagulants was 1.9. (Source:Medscape)
  • An influential US panel of experts says there's just not enough data to decide whether or not e-cigarettes can help smokers quit.
  • Five months after 14 women died in sterilization camps in Chhattisgarh, there is no sign of justice being delivered to those who lost their kin.
  • Research has shown that environmental exposures, such as parental smoking, can play an important role in the initiation and severity of asthma, particularly in children. Recent work at NIEHS suggests that maternal smoking during pregnancy may have trans-generational effects on asthma development. Studying indoor and outdoor exposures, as well as genetics, helps researchers develop cost effective interventions and novel treatments for asthma.
IMA,IJCP,HCFI
Dear Colleague

Human lives are what we save, human suffering is what we treat and human feelings is what we have to soothe.

Is there a scope of an error? Is there a scope of putting our family first or a scope of putting ourselves first? The Sword of Damocles hangs over our heads all the time. Day or night, we give lives of others a priority over our own lives and the lives of our families.

Apollo is making a humble attempt to salute doctors for their tremendous contribution towards the service of the sick against all odds.

We are sharing some videos with you in which real family members of real doctors talk about how they miss their doctor husbands, wives, sons and brothers who spent most of their time with their patients, be it odd hours or special family occasions, yet they say "PROUD OF YOU DOCTOR".

https://www.apollohospitals.com/proudofyoudoctor/

With warm regards

Yours sincerely

Prof. Anupam Sibal
Dr KK Spiritual Blog
Science behind regrets

In a US–based study, dying people were asked about their regrets, if any. The top five regrets were:
  1. I wish I had the courage to live a life I wanted to live and not what others expected me to live.
  2. I wish I had worked harder.
  3. I wish I had the courage to express my feelings.
  4. I wish I had stayed in touch with my friends.
  5. I wish I had let myself to be happier.
Regrets are always based on suppression of emotions or non–fulfillment of desires and needs. These need–based desires can be at the level of physical body, mind, intellect, ego or the soul. Therefore, regrets can be at any of these levels.

I did a survey of 15 of my patients and asked them a simple question that if they come to know that they are going to die in next 24 hours, what would be their biggest regret.

Only one of them, a doctor said that she would have no regrets.

Only one person expressed a physical regret and that was from a Yoga expert who said that her regret was not getting married till that day.

Mental regrets were two.
  1. A state trading businessman said, "I wish I could have taken care of my parents."
  2. A homeopathic doctor said, "I wish I could have given more time to my family."
Intellectual regrets were three.
  1. A lawyer said, "I wish I could have become something in life."
  2. A businessman said, "I wish I could have helped more people."
  3. A retired revenue inspector said, "I wish I had married off my younger child."
Egoistic regrets were two.
  1. One fashion designer said, "I wish I could have become a singer."
  2. A housewife said, "I wish I could have become a dietician."
Spiritual regrets were six.
  1. A Consultant Government Liaison officer said, "I wish I could have made my family members happy."
  2. A businessman said, "I wish I could have meditated more."
  3. A Homeopathic doctor said, "I wish I could have spent more time with my family."
  4. A reception executive said, "I wish I could have spent more time with my parents."
  5. An entertainment CEO said, "I wish I could have taken my parents for a pilgrimage."
  6. A fashion designer said, "I wish I could have worked more for the animals."
In a very popular and successful movie, Kal Ho Na Ho, the hero was to die in the next 40 days. When asked to remember the days of his life, he could not remember 20 ecstatic instances in life.

This is what happens with each one of us where we waste all our days and cannot remember more than 50 or even 20 of such instances. If we are given 40 days to live and if we live every day ecstatically, we can get inner happiness. Therefore, we should learn to live in the present instead of having a habit of postponing everything we do.

We should learn to prioritize our work and do difficult work first or else we would be in a state of constant worry till that work is over.

I teach my patients that they should practice confession exercise and one confession is to talk about your regrets and take them as challenge and finish before the next Tuesday. When working, there are three things which are to be remembered –passion, profession and fashion. Profession is at the level of mind, ego and spirit.

We should convert our profession in such a manner that it is fashionable and passionate. Passion means working from the heart and profession means working from mind and intellect and fashion means working the same at the level of ego which is based on show–off.
Cardiology eMedinewS
  • The FDA approved ivabradine on April 15 for reducing the risk for hospitalization in stable patients with HF (and a resting heart rate of at least 70 bpm on maximally tolerated beta-blockers) without first convening a Cardiovascular and Renal Drugs Advisory Committee (CRDAC) meeting.
  • A review of more than 1.1 million CVD patients who made a primary-care visit to one of 130 VA facilities from October 2013 to September 2014 showed that only 54.8% of those receiving care from nonphysicians, such as nurse practitioners and physician assistants, and 54.0% receiving care from doctors underwent all three performance measures, which included BP monitoring, cholesterol monitoring, and receiving a beta-blocker. Patients who were seen by nonphysicians were more likely to have their BP controlled, whereas those who saw physicians were significantly more likely to receive a beta-blocker or to have cholesterol control through LDL-C monitoring or use of statins (Source: Medscape).
Pediatrics eMedinewS
  • NIAID-funded researchers have found that combined viral and bacterial infections are associated with the increase in asthma symptoms that many children experience during the fall. Children infected with rhinovirus and certain types of bacteria were most likely to experience asthma attacks and cold symptoms. While rhinovirus infection is widely thought to be the main contributor to fall asthma attacks, results of a study published in the May 2014 issue of the Journal of Allergy and Clinical Immunology.
  • Peritoneal drainage is effective initial therapy for most extremely low birth weight (ELBW) infants with spontaneous intestinal perforation, according to a chart review published in J Perinatol 2015.
Make Sure
Situation: A patient with prosthetic heart valves (bioprosthetic) developed infective endocarditis.
Reaction: Oh my God! Why was he not given infective endocarditis prophylaxis?
Lesson: Make sure that all patients with prosthetic heart valves (bioprosthetic or homograft) are given infective endocarditis prophylaxis
Dr Good Dr Bad
Situation: A woman with rheumatoid arthritis became pregnant while taking Leflunomide.
Dr. Bad: You can continue to take it.
Dr. Good: Stop it immediately.
Lesson: In women with rheumatoid arthritis who become pregnant while taking leflunomide, healthy pregnancy outcomes usually occur, if the drug is discontinued at the earliest and a cholestyramine drug elimination procedure is done. (Arthritis Rheum 2010;62:1494)

(Copyright IJCP)
Inspirational Story
Inspiring Tears

Unfortunately when people think of teenagers, good thoughts are not always the first to come to mind. I know I avoid going into my teenage daughter’s high school at the end of their day because I don’t want to shoved and pushed in the hallways. I feel like I am running the gauntlet sometimes! I know they are just kids in a hurry to get out and blow off steam.

Fortunately I also get an opportunity to see teenagers at their best. Watching my daughter and her high school band's camaraderie is always a joy. For instance, when a fellow band member's music folder fell on the pavement everyone ran to help gather the music before it was scattered by the wind. They are a great group of kids.

But I witnessed an event yesterday that really warmed my heart.

My daughter had a band competition at a nearby high school. Her band was the last one to play and before they could play their last selection, the lights in the auditorium flickered and then went out.

The atmosphere in the large, dark space was pensive. The band, sensing this, started singing some of the familiar songs that they sing in the stands during football season. The audience started clapping and singing along. It was quite the experience, sitting in total darkness singing and clapping with dozens of people like it was an everyday occurrence.

I was so lucky to be able to experience this firsthand. My daughter is a senior and so this was one of her last concerts in high school. It was a moving inspirational experience I will never forget.
Events
IMA,IJCP,HCFI
Wellness Blog
Eating Out Tips
  • Curb portions: Always order for one if you are two people and if you are alone set aside some of what is on your plate to bring home.
  • Resist refined carbohydrates.
  • Load your plate with colorful choices at the salad bar with vegetables, fruits, and small amounts of lean protein. Skip the creamy and ranch dressings.
  • Choose dishes that are grilled, roasted, steamed, or sautéed.
  • Don’t be afraid to request a salad, vegetables, or fruit instead of starchy side dishes.
  • In non–vegetarian food, order only fish or seafood.
  • If you decide to have dessert, share it with your dining companion(s).
Quote of the Day
You have to forget about what other people say, when you're supposed to die, or when you're supposed to love. You have to forget about all these things. Jimi Hendrix
eMedi Quiz
Referred pain from ureteric colic is felt in the groin due to involvement of the following nerve:

1. Subcostal.
2. Iliohypogastric.
3. Ilioinguinal.
4. Genitofemoral

Yesterday’s Mind Teaser: All of the following muscles are grouped together as muscles of mastication except:

1. Buccinator.
2. Masseter.
3. Temporalis.
4. Pterygoids.

Answer for yesterday’s Mind Teaser: 1. Buccinator.

Correct Answers received from: Dr K Raju, Dr Shangar Pawar, Dr KC Sharma, Daivadheenam Jella, Dr G Madhusudhan, Dr Ravindra CS.

Answer for 5th May Mind Teaser: 4. Condyles of tibia.

Correct Answers received: Dr Avtar Krishan, Dr KV Sarma, Raju Kuppusamy, Dr G Madhusudhan.
IMA,IJCP,HCFI
Rabies News (Dr A K Gupta)
What are the signs of rabies during the prodromal phase in animals?

Prodromal phase may last for 1–3 days and the animal may show only vague signs of involvement of the central nervous system, which intensify rapidly and death is virtually certain within 10 days after the initial onset of signs.
IJCP Book of Medical Records
eMedinewS Humor
A housewife goes to an optometrist

A housewife goes to an optometrist and says: Lately I’m seeing grocery items smaller than they appeared till recently. I think I need a change of my eyeglasses.

The optometrist after examining her eyes for refraction and finding no change in dioptric values observes: Manufacturers of grocery items, rather than increasing the prices, have made the packings smaller; and there’s no need for you to change your eyewear.
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 101090 trained
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.

Madan Singh, SM Heart Care Foundation Fund, Post CAG

Kishan, SM Heart Care Foundation Fund, Post CHD Repair

Deepak, SM Heart Care Foundation Fund, CHD TOF
eIMA News
Abducted doctor couple returns home after 5 days
Gaya, May 6, 2015, (PTI)
Five days after being abducted, the doctor couple, Pankaj Gupta and Shubhra Gupta, today returned home here in Bihar, Director General of Police P K Thakur said.

However, details are not available right now, Thakur told PTI.

The couple was kidnapped on Friday while they were returning home by car from Giridih in neighbouring Jharkhand where they had gone to attend a wedding function.

Their abduction, allegedly for ransom, created a storm in the political circle as well as medical fraternity with BJP claiming return of "jungle raj" in Bihar.

The Indian Medical Association (IMA) had also threatened to launch a stir if the state government failed to rescue the couple from the clutches of their abductors.

Chief Minister Nitish Kumar had directed the police to take steps to rescue the couple and said he would himself monitor the steps being taken in this regard.

Kumar had also met the doctor couple's relatives at Gaya during his visit there two days ago.
ACP Highlights: Top Studies of 2014
  • A retrospective report found that nearly three-quarters of interval colorectal cancer were missed on colonoscopy, not completely removed, or not detected at biopsy.
  • High adenoma detection rates were associated with decreased risk of interval cancer, supporting the use of the measure as a marker of colonoscopy quality.
  • Stool DNA testing can detect advanced precancerous lesions and colorectal cancer, but cost is high ($500) and specificity is reduced.
  • Patients with inflammatory bowel disease were found to have overall increased risk of cancer. However, risk for gastrointestinal cancer decreased over the past decade while non-gastrointestinal cancer risks remained stable.
  • A modeling study predicted that therapeutic advances and more aggressive screening would make hepatitis C rare in the next 20 years. Cost-effectiveness was not evaluated.
(Source: Medpage Today)
To protest against the killing of Dr RB Choudhary of Gumla, all OPD services suspended on 6th May 2015 in Jharkhand. Private Hospitals and Nursing Homes fully supported IMA and JHASA in their stepwise agitation to demand protection of doctors in general and compensation of Rs 10 crores to the family of victim among other demands. It is unfortunate that the medical profession in the state is not getting due support from the state Government. Doctors have become the softest of the targets. Doctors working in peripheral areas are not safe today due to lawlessness. In case they do not attend to the night emergencies they are suspended by the Government. Hooliganism and violence by unsocial elements against medical professionals is on rise on pretext of medical negligence. Medical Protection Act is not implemented in the state. Government has no sympathy for the medical professionals.

Doctors of this State today do not want to come back to serve here. Medical establishment do not want to invest in this lawless state. For once all medical bodies have joined hands for final fight against the government to get the desired sympathy and protection.

Jogesh Gambhir, President AHPI Jharkhand, Executive Committee Member, Association of Hospitals and Nursing Homes of Jharkhand
Medical Council of India

No.MCI-211(2)/2014-Ethics/100305 Date:01.04.2015

Sub: Guidelines for protection of Good Samaritans in pursuance of directions of Hon’ble Supreme Court of India-regarding.

Sir/Madam,
   It is to inform you that in pursuance of the directions of the Hon’ble Supreme Court of India in WP(civil) no.235/2012 titled as Save Life Foundation & ANR Vs Union of India & ANR the matter was considered by Ethics Committee of the Council at its meeting held on 17th & 18th Nov. 2014. The observation and the decision of the Committee is reproduced as under:-

“The Ethics Committee considered the letter dated 24.09.2014 of Additional Solicitor General Hon’ble Supreme Court forwarded by Under Secretary. Govt. of India, Ministry of Health & Family Welfare vide their letter dated 28.10.2014. The Committee noted the Supreme Court direction in WP No. 235 of 2012 titled as “Save Life Foundation & Others Vs Union of India and Ors” pending in the Hon’ble Court.

In this connection, the Ethics committee noted that as per Indian Medical Council Act, 1956, does not have any administrative jurisdiction over the hospitals or clinical establishment. The Council has the jurisdiction only for purposes of teaching.

   In view of above, the Ethics Committee was of the view that an Advisory be sent to all the State Medical Councils, Dean/Directors of Medical Education, Vice Chancellors of the Universities, Indian Medical Association and all the State Medical Councils that they should issue Advisory and instructions informing all the doctors registered or working in the respective institutions of ensuring that in case of emergency situations pertaining to the road accidents or any other emergent situation, doctors should attend the patients and given them emergency treatment.

The Ethics Committee was also of the view that Advisory is only for with regard to financial aspect, the State should develop a mechanism to reimburse as per rates”

The said decision has been approved by the Executive Committee at its meeting held on 13.01.2015.

In view of above, I am directed to request you to issue an advisory and instructions to all the doctors registered and/or working under jurisdiction ensuring that in case of emergency situation pertaining to the road accidents or any other emergent situation, doctors should attend the patients and give them emergency treatment immediately failing which, the state Medical Council and/or Medical Council of India may take appropriate action against the erring doctors under the provisions and Indian Medical Council (Professional Conduct Etiquette and Ethics) Regulations, 2002.

A copy of the order of the Hon’ble Apex Court is attached herewith for your ready reference.

                                                            Yours faithfully

                                                             (Dr. Reena Nayyar)

                                                             Secretary I/C
ITEM NO. 205                                       COURT NO 11
SECTION PIL

SUPREME COURT OF INDIA
RECORD OF PROCEEDINGS

WRIT PETITION (CIVIL No. (s). 235/2012

SAVELIFE FOUNDATION & ANR
Petitioner(s)

VERSUS

UNION OF INDIA & ANR
Respondent(s)
(FOR FINAL DISPOSAL)

Date: 14/08/2014. This is petition was called on for hearing today

CORAM:
HON’BLE MR. JUSTICE RANJAN GOGOI
HON’BLE MR. JUSTICE R.K. AGRAWAL

For Petitioner(s)                    Ms. Indu Malhotra, Sr. Adv.
                                             Mr. Vivek Jain, Adv.
                                             Mr. Senthi Jagadeesan, Adv.
                                             Ms. Nishtha Kumar. Adv.
                                             Mr. Apoorva Bhumesh, Adv.

For Respondent (s)            Ms. Pinky Anand, ASG
                                          Mr. J.S. Attri, Sr. Adv.
                                          Ms. Sunita Sharma Adv.
                                          Mr. R.K. Rathore, Adv.
                                          Mr. S.S. Rawat, Adv.
                                          Ms. Namrata Sharma, Adv.
                                          Mr. D.S.Mahra, Adv.
                                          Ms. Natasha Sehrawat, Adv.

UPON hearing the counsel the Court made the following
ORDER

      We have read and considered the report dated 3rd January 2014 finalized by Shri K. Skandan, Additional Secretary (CS & K) who was appointed by order dated 21st October, 2013 as the Ad-hoc Chairman of the Court Constituted Committee.

      The aforesaid reconstitution of the Committee was necessitated by the inability of former Chairman, Mr. Justice V.S. Agarwal, former judge, Delhi High Court to continue in the said capacity.

      A perusal of the report dated 3rd January, 2014 indicated that several of the recommendations relate to road safety and therefore, would have similarity to the issues that have been referred by this Court to another Court Appointed Committee by its order dated 22nd April, 2014 passed in Writ Petition (Civil) No. 295 of 2012 (S. Rajaseekaran Vs Union of India and others)

      However, there is one significant aspect in the recommendations of the present committee which needs immediate attention. The said recommendations have been paraphrased in the Report under the Head ‘Recommended directions in relation to protection of Good Samaritans’.

      Learned counsel for the petitioners has contended that the said recommendations of the Ad-hoc Committee headed by the Additional Secretary can reasonable form the basis of an exercise ….er Article 32 of the constitution of India to issue directions ……il framing of appropriate laws by the Legislature. Learned …… has also pointed out that the Committee was headed by a ….Official of the Government of India and that the Union of India was adequately represented in the said Committee.

      However, Ms. Pinky Anand, learned Additional Solicitor……… appearing for the Union of India has submitted that the matter is presently engaging the attention of the Ministry of Law and Justice and that the views of the Ministry particularly with regard to the necessity of amendments in existing laws/enactments of new laws should be allowed to be placed before this Court.

      Having heard the learned counsels for the parties, we are of the view that before proceeding to exercise the jurisdiction under Article 32 of the Constitution of India to issue binding directions pending enactment of laws by the Legislature. It will be fruitful to heave the views of the union of India in the concerned Ministry on records.

      We, therefore grant four weeks’ time to the Union of India to place its said views in the matter.

      We have already observed that a part of the Report of Shri K. Skandan, Additional Secretary (CS & K) deals with the matters which are presently before the Court Appointed Committee headed by Mr. Justice K.S. Radhakrishan, former Judge of this Court.

      In view of the above position, we request Ms. Pinky Anand, learned Additional Solicitor General to submit a status Report with regard to the constitution and working of the Court appointed Committee and the progress made by the said Committee in performance of the task assigned to it by order dated 22nd April, 2014 passed in Writ Petition (Civil) No. 295 of 2012. A copy of this order be also sent to the Member Secretary of the Committee headed by Mr. Justice K.S. Radhakrishnan so as to enable the Member Secretary to place before this Court the difficulties, if any, that the Committee headed by Mr. Justice K.S. Radhakrishnan may be encountering in performing and completing its assigned task.

List the matter again on 24th September, 2014

(VINOD LAKHTNA CHAKRABORTY)              (TAPAN KUMAR)
COURT MASTER                                          COURT MASTER
IMA Releases Asthma White Paper on World Asthma Day
By EH News Bureau on May 5, 2015

The White paper has listed important aspects related to asthma control

One should not ignore the first attack of asthma after the age of 40 and either cough or acidity may be the only signs of asthma, says the Asthma White Paper released by IMA on the occasion of World Asthma Day

According to the Asthma White Paper, if asthma is not controlled, it may be fatal, inform Dr A Marthanda Pillai National President IMA and Dr KK Aggarwal Honorary Secretary General IMA. The White paper has also listed important aspects related to asthma control. The following are:
  1. Do not ignore the first attack of asthma after the age of 40, it may be of heart in origin.
  2. All wheeze is not asthma and all asthmatics do not wheeze.
  3. Only cough may be a sign of asthma.
  4. If a patient is able to speak a sentence during an asthma attack, then he or she does not have severe asthma.
  5. If one gets an attack of asthma more than twice in the night in a month or more than twice during day time in a week, he or she needs continuous asthma treatment
  6. All asthmatics should be questioned about symptoms triggered by common inhaled allergens, at home, day care, school, or work
  7. Indoor allergens, such as dust mites, animal danders, molds, mice and cockroaches, are of particular importance.
  8. Food allergy rarely causes isolated asthma symptoms, although wheezing and cough can be symptoms of food-induced anaphylaxis.
  9. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) may trigger symptoms of asthma in about 3-5 per cent adult asthmatic patients. Asthmatic patients with nasal polyps have a higher incidence of aspirin-exacerbated respiratory disease. Aspirin-sensitive asthma is uncommon in children.
  10. Non-selective beta-blockers, even in the very small amounts that are absorbed systemically from topical eye drops, can trigger severe attacks of asthma. Selective beta-1 blockers can also aggravate asthma in some patients, especially at higher doses.
  11. Gastric reflux is common among patients with asthma. The prevalence of the gastroesophageal reflux among patients with asthma ranges from 30-90per cent. Look for asthma symptoms after eating certain foods (e.g., high fat food, chocolate, peppermint, caffeine, alcohol).
  12. Well-controlled asthma means daytime symptoms no more than twice per week and night-time symptoms no more than twice per month.
  13. Exercise-induced asthma is asthma that occurs after exercise in many asthmatic patients. All patients with asthma, when exercising, should have a rapid-acting beta-agonist drug available for relief of asthma symptoms. In well-controlled asthmatic patients, but who frequently have asthma symptoms with exercise, prophylactic use of a rapid-acting beta-agonist about 10 minutes prior to exercise is recommended. Avoiding exercise in cold, dry air can also reduce the stimulus for exercise-induced asthma. Oral theophylline and oral beta agonists are minimally effective or ineffective for exercise-induced asthma.
  14. All asthmatics should buy an asthma meter (peak flow meter) and keep it above 60% of normal range.
  15. Inhalers are better than oral drugs.
  16. Inhaled irritants include tobacco smoke, wood smoke from stoves or fireplaces, strong perfumes and odors, chlorine-based cleaning products and air pollutants. Patients should be cognizant of avoiding irritants and avoid exertion outdoors on days when levels of air pollution are high.
  17. Annual administration of influenza vaccine is recommended for patients with asthma as they are particularly at risk for complications of influenza infection. But, vaccination does not reduce the number or severity of asthma exacerbations during the influenza season. Physicians should ensure that patients understand this distinction.
  18. Administration of pneumococcal vaccination is recommended for all those adults whose asthma is severe enough to require controller medication and for children with asthma who require chronic treatment with oral steroids.
  19. Sulfite compounds are used in the food industry to prevent discoloration. Significant and reproducible exacerbations may occur after ingestion of sulfite-treated foods and beverages, such as beer, wine, processed potatoes, dried fruit, sauerkraut, or shrimp.
  20. Near-fatal and fatal asthma exacerbations may occur in patients with mild, moderate, or severe asthma and the course may be either slow or rapid in onset. A recent history suggestive of poor asthma control or any prior history of endotracheal intubation and mechanical ventilation for asthma should alert the physician that the patient is at high-risk for near-fatal asthma exacerbations. Other factors include long duration of asthma, poor adherence to medical therapy, systemic glucocorticoid dependence, psychosocial problems, aspirin/NSAID sensitivity, cigarette smoke exposure, prior hospitalisation for asthma and aeroallergen exposure in sensitised individuals.
8th May is World Thalassemia Day
Mentzer index: If the quotient of the mean corpuscular volume (MCV, in fL) divided by the red blood cell count (RBC, in millions per microLiter) is less than 13, thalassemia is said to be more likely. If the result is greater than 13, then iron-deficiency anemia is said to be more likely.
Sonal Namaste
Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others.
Media
IMA,IJCP,HCFI
Union Minister Shripad Naik launches ETHealthworld.com
ETHealthworld.com aggregates news and information from multiple sources - locally and globally; breaks new stories online and gives insightful analysis on health and pharma industry.
New Delhi, MAY 6, 2015 : ETHealthworld.com - an initiative of The Economic Times, was launched today with GE as the founding partner. The portal is intended to play a crucial role in the rapidly changing healthcare and pharmaceutical world.

Union Minister of State, Ministry of Health & Family Welfare, Shri Shripad Yesso Naik has launched the portal on Wednesday. ETHealthworld is envisaged to be a one stop platform that will cater to the pulse of the healthcare and pharma industry. Be it business, policy, research, news and analysis, the portal aims to keep readers abreast of the latest developments in all verticals of healthcare sector.

ETHealthworld.com also reaches to its readers through a comprehensive daily E-newsletter, summarising day's news and analysis and has got over 50,000 pre-launch readership of decision makers, policy makers, Hospital CEOs, senior doctors and professionals in health industry in India. The portal is slated to play significant role in facilitating B2B transactions by publishing relevant data, reports, surveys and other information on the healthcare and pharmaceutical industry.

Milan Rao, Pesident & CEO, India & South Asia said, "We are proud to be the founding partners of ETHealthworld.com. The portal is a platform which enables us to provide data, news and education about the healthcare sector not only to the professionals in the industry but also to the investors and public at large.

ETHealthworld.com has received widespread support and encouragement from top industry bodies like Indian Medical Association (IMA), Healthcare Foundation of India (NATHEALTH), Public Health Foundation of India (PHFI) and Indian Dental Association (IDA) among others."
IMA in Social Media
https://www.facebook.com/ima.national 28298 likes
https://www.facebook.com/imsaindia 45563 likes
https://www.facebook.com/imayoungdoctorswing 1214 likes
Twitter @IndianMedAssn 942 followers
http://imahq.blogspot.com/ www.ima-ams.org
http://www.imacgpindia.com/ http://www.imacgponline.com/
http://www.ima-india.org/ima/
www.indianmedicalassociation.info
IMA Videos
News on Maps
IMA wants Central Act to combat violence against doctors and their medical establishments
In the last one week, the medical profession has seen doctors being abducted. Dr RB Choudhury of Gumla District of Jharkhand was kidnapped from his clinic on 30th April, 2015 and was found dead on 4th May, 2015.

Another doctor, Dr Pankaj Gupta from Bihar was also kidnapped on May 1 along with his wife; the couple is still untraceable.

The Indian Medical Association (IMA) has expressed concern about the recent incidents of assault on doctors as well as kidnapping of doctors.

Addressing a Press Conference, Padma Shri Awardee, Prof (Dr) A Marthanda Pillai, National President IMA and Padma Shri Awardee, Dr K K Aggarwal, Hony Secretary General, IMA in a joint statement said Governments of 18 states have passed Ordinances (Prevention of Violence and Damages or Loss of Property) against the violence on doctors and medical establishments The time has now come for the Central Govt. to enact the same.

IMA is preparing a draft Bill for the submission to the Govt. of India to enact the same at the earliest.

Talking about Dr RB Choudhury, the IMA office bearers said that the case should be investigated at the earliest and investigation should be handed over to the Crime Branch/CBI. Similarly, the case of Dr Pankaj Gupta should also be solved immediately.

Doctors in Jharkhand and Bihar have gone on strike and are protesting on the roads.

IMA will be forced to go on a nationwide agitation and protest, if the above cases are not solved and the Central Act is not enacted by the Govt.
Reader Response
Dear Sir, thanks for updating. Regards: Dr Kartik