June 7  2015, Sunday
eMedinewS
editorial
Eating foods in their natural form is always better
Dr KK Aggarwal An elephant is obese, eats sugarcane and yet does not develop diabetes. I am sure if he were given 10% sugar drinks everyday or made to eat sweets containing 30% sugar, he would end up with diabetes.

The natural form of sugarcane is eating sugarcane in its raw form, the second form is sugarcane juice, third is gur (jaggery), fourth is shakkar and fifth is white sugar.

The more you eat foods in their natural form, more the health benefits you will get from that food.

Food is Brahmin and contains the same consciousness as you have. Refined foods lose their consciousness and are not beneficial to the health.

Similarly, wheat flour with bran is better than flour without bran, which is better than suji, which is better than maida (refined flour), which is the final product. If refined flour is taken every day, it can cause heart disease, diabetes and high blood pressure.
IMA,IJCP,HCFI
eMedipics IMA,IJCP,HCFI
First of its kind Jan Aushadhi Medical Store at the Indian Medical Association to make affordable healthcare a reality
IMA,IJCP,HCFI
News
  • The WHO Strategic Advisory Group of Experts on immunization has recommended introduction of one or more IPV doses into EPI routine immunization schedule, followed by a global, synchronized switch from tOPV to bOPV at birth and 6, 10, and 14 weeks of age
  • The US Food and Drug Administration (FDA) has approved the injectable dermal filler Radiesse for hand augmentation to correct volume loss in the dorsum of the hands.
  • A new study has found an association between type 2 diabetes and a lower risk for amyotrophic lateral sclerosis (ALS), while type 1 diabetes was associated with a higher risk. The study was published online June 1 in JAMA Neurology.
  • A new study points towards a high incidence of osteopenia and a significant risk for osteoporosis in men with low levels of testosterone. The study presented at the American Urological Association (AUA) 2015 Annual Meeting also suggested that the longer these patients are hypogonadal, the greater the risk.
  • A single IV dose of fosaprepitant may reduce chemotherapy-induced nausea and vomiting, suggested a new phase III trial presented at the American Society of Clinical Oncology meeting.
Dr KK Spiritual Blog
I am the Best

People who lack self–confidence and self-esteem face recurrent episodes of depressions. They suffer from inferiority complex as all the time they compare themselves with others.

It’s a common saying that "everyone like someone else’s wife, money and their own buddhi or intelligence".

An organization is good or bad is decided by its people. If the people are good the organization is good and if the people are bad the organization is bad. An organization without people is only a building made up of bricks.

Imagine a situation where two students of a school are asked "how is your school". The first student answers: "My school is the best" and the second one says: "My school is not the best". The teacher’s reply to both the students is the same: "It has to be because students like you are there in this school. It’s you who will make the school best or not the best.”

Whichever organization you work for, it has to be the best, because you are working there and because you are the best. If it was not the best you would not have been there. The mantra of success lies in the self affirmation of "I am the best."

Everybody is born with a hidden talent. One should only look for positive things in oneself and others. One should never compare oneself with others, as one does not know how many bad things they might be harboring in them.

You have to be the best as God selected you as a human being. Remember, a human being is born passing through 84 lakhs of different kinds of living species.

The Eastern scripture explains that in this world there are approximate 84 lakh of species of living beings which include 3 million species of plant life; 2 million 7,00,000 species of insects; 1 million 4,00,000 kinds of birds; 9,00,000 kind of water animals and 4,00,000 kind of land animals including men.

One therefore, should not only look oneself through the eyes of flesh but also through the eyes of mind and soul. One should not only analyze one’s physical profile but also the ego and soul profile.

External beauty is important but is incomplete without the beauty of the mind and of the soul. Ashtawakra Gita was a dialogue between the sage Ashtawakra and Raja Janaka. Ashtawakra was a person with eight curves in the physical body. But his soul profile was unmatchable.
Cardiology eMedinewS
  • Sleep disturbances and psychosocial factors may affect quality-of-life outcomes in patients with implantable cardioverter defibrillators (ICDs), suggests new research presented at the Heart Failure Congress 2015.
  • The use of post-stent ballooning (post-SB) in carotid artery stenting (CAS) seems to double the risk of hemodynamic depression and perioperative stroke and death, suggests a retrospective analysis of patients from the Vascular Quality Initiative database. The findings are published in the Journal of Vascular Surgery.
Pediatrics eMedinewS
  • Pregnant women living closest to gas wells drilled with hydraulic fracturing may be more likely to have babies with lower birth weights than those living farther away, suggests a new study published in PLoS One.
  • Children with ADHD have an increased risk for affective comorbidities if their mother suffered abuse as a child, suggests new research presented at the 5th World Congress on Attention Deficit Hyperactivity Disorder (ADHD).
Make Sure
Situation: A patient with LDL cholesterol 100 mg% and hsCRP 3 developed MI
Reaction:Oh my God! Why was a statin not started earlier?
Lesson: Make sure that all patients with even normal cholesterol are considered for statins if the hsCRP is high.
Dr Good Dr Bad
Situation: A patient came with blood lead levels of 20 mcg/dl
Dr Bad: Start chelation
Dr Good: Eliminate the lead sources
Lesson: In most cases of mildly elevated lead levels (>20 mcg/dL), removal of the patient from the exposure may be the only therapy indicated.

(Copyright IJCP)
Inspirational Story
The Power of Good Words

A group of frogs were traveling through the woods, and two of them fell into a deep pit.

All the other frogs gathered around the pit. When they saw how deep the pit was, they told the unfortunate frogs they would never get out. The two frogs ignored the comments and tried to jump up out of the pit.

The other frogs kept telling them to stop, that they were as good as dead. Finally, one of the frogs took heed to what the other frogs were saying and simply gave up. He fell down and died.

The other frog continued to jump as hard as he could. Once again, the crowd of frogs yelled at him to stop the pain and suffering and just die. He jumped even harder and finally made it out. When he got out, the other frogs asked him, "Why did you continue jumping? Didn't you hear us?"

The frog explained to them that he was deaf. He thought they were encouraging him the entire time.

This story holds two lessons:

1. There is power of life and death in the tongue. An encouraging word to someone who is down can lift them up and help them make it through the day.

2. A destructive word to someone who is down can be what it takes to kill them. Be careful of what you say. Speak life to those who cross your path.

The power of words… it is sometimes hard to understand that an encouraging word can go such a long way. Anyone can speak words that tend to rob another of the spirit to continue in difficult times.

Special is the individual who will take the time to encourage another.
Events
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eMedi Quiz
The substances present in the gall bladder stones or the kidney stones can be best identified by the following technique:

1. Fluorescence spectroscopy.
2. Electron microscopy.
3. Nuclear magnetic resonance.
4. X-ray diffraction

Yesterday’s Mind Teaser: The following separation technique depends on the molecular size of the protein:

1. Chromatography on a carboxymethyl cellulose column.
2. Iso-electric focusing.
3. Gelfiltration chromatography.
4. Chromatography on a diethylaminoethyl cellulose column.

Answer for yesterday’s Mind Teaser: 3. Gelfiltration chromatography.
Correct Answers received from: Dr Jainendra Upadhyay, Dr.K.Raju, Dr Poonam Chablani, Dr K V Sarma, Dr MadhuSudhan G, Daivadheenam Jella.
Answer for 5th June Mind Teaser: 1. Glyceraldehyde-3-phosphate dehydrogenase
Correct Answers received: Tukaram Pagad, Dr K V Sarma, Dr MadhuSudhan G, Dr Avtar Krishan, Daivadheenam Jella.
eMedinewS Humor
Wonderful confession by a girl in church and amazing reply she got.

She: I m in love with a boy who is far away from me.
I’m in India and he lives in UK.
We met on marriage website.
Became friends on FB.
Had long chats on WhatsApp.
Proposed each other on Skype.
N now 2 months of relationship through Viber.
I need your blessings and good wish, Oh God.

Guy besides her said: Now get married on Twitter.
Have fun on Tango.
Buy your kids from eBay.
Send them through gmail.
And if you are fed up with your husband or kids then, unko OLX pe bech de
IMA,IJCP,HCFI
Rabies News (Dr A K Gupta)
We often hear that the patient died of rabies but the biting dog was still alive. Is it possible?

It is not possible.
IJCP Book of Medical Records
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
Press Release
Low Vitamin D Linked to Heart Risk

Low blood levels of vitamin D are associated with an increased risk of cardiovascular problems such as heart attack and stroke, said Padma Shri, Dr. B C Roy & DST National Science Communication Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General Indian Medical Association.

The 5-year research with participants in the Framingham Heart Study was published in the journal Circulation. The study, which included 1,739 people, average age 59 years, found that those with the lowest levels of vitamin D had a 62 percent greater risk of a cardiovascular event than those with the next highest levels.

An hour or so of sunlight on the skin each week allows the skin to produce blood levels of about 30 nanograms of vitamin D per liter of blood, more than enough to prevent a deficiency such as rickets.

Food sources of vitamin D include fortified milk and oily fishes such as salmon.

Recommendations from the Institute of Medicine in the United States call for a daily intake of vitamin D ranging from 200 International Units (IU) for young people, to 400 IU for the middle-aged, to 600 IU for older people. But getting that amount from food and sunlight may not be easy. A glass of fortified milk contains only about 100 IU of vitamin D. The suggested recommendation is 1,000 - 2,000 IU.

The cardiovascular risk associated with low vitamin D levels was especially greater for people who also had high blood pressure. Their incidence of cardiovascular events was double that of people with higher blood levels of vitamin D.
eIMA News
Health ministry moots online sale of drugs; regulator works on guidelines
Shri JP Nadda
Hon'ble Health Minister for Health & Family Welfare
Govt of India
New Delhi

Respected Sir

Greetings from Indian Medical Association!

This has reference to the news item published in TOI today. "Health ministry moots online sale of drugs; regulator works on guidelines."
  1. Health ministry is evaluating a proposal. The drug quality regulator is framing guidelines and mechanism to monitor such sale.
  2. The proposal is expected to be taken up for discussion in the drugs consultative committee meeting next month
  3. Drugs & Cosmetics Act does not allow sale of Schedule 'H' medicines without a doctor's prescription. In fact, even over-the-counter (OTC) pharmaceutical products can be sold only by licensed retailers.
  4. "With changing trends, it is important that we bring in provisions for online sale of medicines and develop a mechanism to monitor it," the official said. The Drugs Controller General of India (DCGI) has also asked state drug regulators to suggest mechanisms to monitor such sale.
  5. The central regulator is also consulting various international drug regulatory agencies such as the US Food and Drug Administration (FDA) and the European Medicines Agency as well as examining their models to understand how quality and standards of medicines sold through e-commerce portals are monitored in these countries
Sir, this proposal is not without risks for the society. To give a few examples:
  1. The quality, efficacy and standards cannot be maintained.
  2. Even paracetamol can be fatal in overdose. The therapeutic dose is 10 to 15 mg/kg per dose in children and 325 to 1000 mg per dose in adults, with a maximum recommended daily dose of 80 mg/kg in children or 4 g in adults. A single toxic dose is more than 150 mg/kg in a child or 7.5 to 10 g for an adult. Toxicity is likely to occur with single ingestions greater than 250 mg/kg or those greater than 12 g over a 24-hour period.
  3. Diagnosis of chronic paracetamol is also common. Ingestion of greater than 7.5 to 10 g of paracetamol over 24 hours, or ingestion of greater than 4 g over 24 hours AND have an increased susceptibility to hepatotoxicity (e.g., chronic alcohol use, fasting, use of P450-inducing drugs) can lead to liver toxicity. Supratherapeutic paracetamol concentrations (greater than 20 mcg/mL, or 130 micromol/L) can be dangerous
  4. Use of aspirin in children for fever can led to dangerous Reye syndrome.
  5. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of medications used for analgesic and anti-inflammatory benefits. NSAIDs can induce several different forms of kidney injury. All nonselective NSAID- or cyclooxygenase (COX)-2-specific NSAIDs may cause kidney injury. Risk factors include chronic kidney disease, volume depletion, vomiting or diarrhea, heart failure, cirrhosis. Medications including diuretics and angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) may increase the risk of NSAID-induced AKI. Higher doses of NSAIDs are associated with a greater risk of kidney injury. NSAID-induced AKI may be prevented by avoiding NSAIDs among high-risk patients. Chronic use of NSAIDs should be avoided if at all possible among patients with a reduced eGFR (eGFR <60) and used cautiously, even if the reduction is mild (eGFR 60 to 89).
  6. Many drugs in the elderly can precipitate urinary retention. Most common among these are the anti-cholinergic (belladona), anti-histamines (Benadryl) and sympathomimetic drugs (nasal decongestants)
Sir, IMA is the largest medical NGO of the world with over 2.5 lakh doctors. Kindly do not come out with any policy without consulting IMA.

Today most chemists are prescribing drugs illegally and the government is not able to control them. Adding online pharmacists will add oil to the fire.

With kind regards,

Yours sincerely,

Dr A Marthanda Pillai          Dr K K Aggarwal
National President, IMA        Hony Secretary General, IMA

Reply: Dear Dr. Pillai, Thank you for your email. I will have the information passed on and looked into by the relevant division in my office.

Regards,

Jagat Prakash Nadda
Union Health Minister
Sonal Namaste
Patients with an identifiable cause of bad breath e.g., periodontal (gum) disease, gingivitis, postnasal drip, systemic illness can be treated for these conditions.

Many cases of bad breath may be readily alleviated by:
  • Proper dental care and oral hygiene, including daily flossing.
  • Gentle cleaning of the posterior portion of the dorsum of tongue (e.g., with a plastic tongue cleaner).
  • Rinsing and deep gargling with an effective mouthwash (in order to get the liquid as far back as possible without swallowing it, one can extend the tongue while gargling). This is most effective when done at bedtime.
  • Eating fibrous foods (a healthy breakfast is recommended).
  • Chewing gum briefly (5 minutes is often sufficient) if the mouth is dry, or after meals, especially with high protein intake. Sugar-free gum is preferable.
  • Sufficient water intake.
  • Decreasing alcohol and coffee intake.
IMA Swatch Bharat Swasth Bharat Initiative
Lead levels
  • Normal levels in children < 5 mcg/dL
  • Normal levels in adults < 10 mcg/dL
  • Low lead levels 20 to 29 mcg/dL
  • Moderate levels 30 to 70 mcg/dL range (1.45 to 3.38 micromol/L) may be asymptomatic or have vague symptoms such as fatigue, myalgia, insomnia, difficulty concentrating
  • Consider chelation if lead levels are more than 100 mcg/dL, levels between 80-100 mcg/dL in asymptomatic individuals and between 50-80 mcg/dL (2.41 to 3.86 micromol/L) in symptomatic patients
  • Primary care physicians should refer patients with raised levels of lead, >20 mcg/dl
Pills that won’t add to your medical bills
Bindu Shajan Perappadan

IMA opens first Jan Aushadhi medical store

The Indian Medical Association (IMA), the country’s largest non-government organisation of doctors, launched its first-ever Jan Aushadhi Medical Store at IP Estate — its headquarters — on Friday.

The store, which will offer over 118 commonly used drugs in their generic forms at 80-90 per cent lesser cost than its market price, was inaugurated by Minister of State for Chemicals and Fertilisers Hansraj Gangaram Ahir.

The Minister noted that “supplying quality drugs at affordable prices can reduce the monthly expenditure of a common man and substantially reduce his financial burden”.

All the medicines being offered at the IMA Jan Aushadhi Medical Store have been approved by the Jan Aushadhi Department and quality controlled by the Bureau of Pharma Public Sector Undertakings of India.

The store will remain open from 9.30 am to 6.30 pm on all working days of the week. A full-time qualified pharmacist will not only dispense drugs at the store but also counsel patients about the drug-drug and drug-food interactions and report adverse events.

IMA official Dr. K.K. Aggarwal said: “With the existence of a large gap in the socio-economic set up of our country and the ever-increasing disease prevalence due to lifestyle factors; affordable healthcare for all is an urgent need and necessity.”

The IMA Jan Aushadhi Medical Store, the doctors hope, will help in drastically bringing down the monthly amount spent by families on essential life-saving drugs such as painkillers, medicines for fever and medicines to control diabetes, amongst others.

“Once successful, all State Branches of IMA will be requested to open similar centres on their premises. General practitioners across the NCR will also be requested to buy drugs from IMA Centre and dispense it to their patients,” added Dr. Aggarwal.

In a joint statement, Sudhansh Pant, Joint Secretary, Ministry of Chemicals and Fertilizers, Dr. G.N. Singh, Drugs Controller General India and Injeti Srinivas, Chairman, National Pharmaceutical Pricing Authority, said: “The IMA Jan Aushadhi Medical Store will go a long way in reducing the healthcare burden of our country. Affordable and accessible healthcare for all is of utmost importance to the Indian Government and associated policy-makers.”

The store will offer over 118 drugs at a 10-20% lesser price compared to the market price
Janaushadhi Store Launched in Delhi-to Provide Medicines at Affordable Rates
Press Information Bureau
Government of India
Ministry of Chemicals and Fertilizers
05-June-2015 18:22 IST


The Minister of State for Chemicals & Fertilizers, Shri Hansraj Gangaram Ahir today inaugurated the Jan Aushadhi Generic Drug Store at IMA House, New Delhi. Speaking on the occasion, the Minister said that Jan Aushadhi Yojana, will be relaunched in the month of August 2015 in a big way. He said that about 1000 Stores of Jan Aushadhi will be opened to provide quality generic medicines at affordable rates to the entire population of the country. He hailed the efforts of the Indian Medical Association (IMA) in opening the Jan Aushadhi Stores in their premises and expressed hope that they will help in creating awareness among the doctor’s community to prescribe generic medicines.

The Minister said that these stores will be opened for the underprivileged who would be provided medicines at a price of 60-70% less than the market price. The Minister said that the stores will be renamed, rebranded and will increasingly involve B. Pharma and M. Pharma qualified unemployed populace.

Dr. K. K. Agarwal, Honorary Secretary General, IMA, lauded the efforts of the Government of India in promoting Jan Aushadhi Scheme and providing low cost quality medicines available for all through dedicated stores. The IMA also requested the Government to include generic versions of expensive medicines and medical devices like those relating to treatment of cancer, heart surgery etc., in the list of Jan Aushadhi products.
Govt. launches Jan Aushadhi medical store in Delhi
By ANI: New Delhi, June 5 (ANI): Minister of State for Chemicals and Fertilizers Hansraj Gangaram Ahir on Friday inaugurated the Jan Aushadhi Generic Drug Store at Indian Medical Association (IMA) headquarters here.

Ahir said that Jan Aushadhi Yojana would be re-launched in the month of August 2015 in a big way.

He said that about 1000 Stores of Jan Aushadhi would be opened to provide quality generic medicines at affordable rates to the entire population of the country.

The Minister hailed the efforts of the Indian Medical Association (IMA) in opening the Jan Aushadhi Stores in their premises and expressed hope that they would help in creating awareness among the doctor's community to prescribe generic medicines.

He further said that these stores will be opened for the underprivileged who would be provided medicines at a price of 60-70 percent less than the market price.

The Minister said that the stores will be renamed, rebranded and will increasingly involve B. Pharma and M. Pharma qualified unemployed populace.

Dr. K. K. Agarwal, Honorary Secretary General, IMA, lauded the efforts of the Centre in promoting Jan Aushadhi Scheme and providing low cost quality medicines available for all through dedicated stores.

The IMA also requested the government to include generic versions of expensive medicines and medical devices like those relating to treatment of cancer, heart surgery etc., in the list of Jan Aushadhi products. (ANI)
5 truths about protecting your eyes
Myth: Reading in dim light will worsen your vision.

Fact: Dim lighting will not damage your eyesight. However, it will tire your eyes out more quickly. The best way to position a reading light is to have it shine directly onto the page, not over your shoulder. A desk lamp with an opaque shade pointing directly at the reading material is ideal.
  • Wet your hands with running water — either warm or cold.
  • Apply liquid, bar or powder soap.
  • Lather well.
  • Rub your hands vigorously for at least 20 seconds. Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.
  • Rinse well.
  • Dry your hands with a clean or disposable towel or air dryer.
  • If possible, use a towel or your elbow to turn off the faucet.
Dr Dang's Lab gets extension for operating from the same premises (D-1, Hauz Khas) for another two months. (Till 29th August)
News
  • Tasty menu items may soon replace the foul-tasting purgatives typically used to prepare the bowel for colonoscopy that are so difficult to swallow and unpopular with patients, they can impede cleansing.
  • SAVOR-TIMI trial of saxagliptin, which showed an increase in rates of congestive heart failure requiring hospitalization.
  • Moderate exercise during pregnancy can decrease the risk for gestational diabetes by 31% and also can reduce maternal weight gain, according to a meta-analysis of randomized controlled trials published online June 3 in the British Journal of Obstetrics and Gynecology.
  • Results from two major cardiovascular safety trials of diabetes drugs will make headlines at the American Diabetes Association (ADA) 2015 Scientific Sessions, which will also feature a wide range of cutting-edge science, state-of-the-art information, and a celebratory look back. The conference runs from June 5 to June 9, 2015 in Boston, Massachusetts.
  • One of the key messages coming from the IMPROVE-IT trial, published this week in the New England Journal of Medicine, is that "lower is better" for LDL cholesterol regardless of the specific agent used to get there. Should this trial be enough to change the American Heart Association/American College of Cardiology guidelines back to using a treatment target? If so, should the former 70 mg/dL target become a 50 to 55 mg/dL target as achieved in the IMPROVE-IT intervention group?
  • Obstructive sleep apnea (OSA) may increase the risks of death, heart disease, stroke, and kidney disease, as well as hasten kidney function decline, according to a study of more than 3 million U.S. veterans published in thorax
Media
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Wellness Blog
All About Calcium Carbide
  • Under PFA Section 44AA, the use of calcium carbide for artificial ripening of mangoes, apple, plum, banana is prohibited and can attract both imprisonment and fine.
  • Calcium carbide powder is usually kept wrapped in paper between the fruits (unripe mangoes) in a basket or box.
  • Once the basket of mango is closed from the top, calcium carbide absorbs moisture and produces acetylene gas, which accelerates the ripening process of fruits.
  • The health hazards are related to the gastrointestinal tract, kidney, heart, liver and brain and in long run cancer.
  • One kg of calcium carbide is sufficient to ripe 10 tons of fruit.
  • How do we know that the fruit has been artificially ripened with calcium carbide?
    • It will be less tasty.
    • The aroma will be different
    • It is uniform in color.
    • The color of the mango changes from green to dark yellow.
    • It will have shorter shelf life.
    • It will be overtly soft.
    • There may be black patches on the mango skin.
    • There may be multi color patches on the skin of the mango (Red, yellow, green patches)
  • How should artificially ripened fruits be handled?
    • Never eat off-season fruits, especially before time
    • Rinse all fruits in running tap water for few minutes before use.
Quote of the Day
You will never do anything in this world without courage. It is the greatest quality of the mind next to honor. Aristotle
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Reader Response
Thank you for the news bulletin which is very informative, as usual. Although I am a gynecologist I find the general information in the bulletin very interesting and useful. Regards, Dr Jayashree Joshi, Mahim, Mumbai.
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