July 7  2015, Tuesday
eMedinewS
editorial
5 Ways to Stop A–Salting Your Kidney
Dr KK AggarwalEating white salt is like a slow poison. If the amount of salt is reduced to less than 1 teaspoon per day, a large percentage of people with high blood pressure will have normal blood pressure.

High salt intake via increase in blood pressure leads to kidney damage over a period of time and kidney failure. Consume less, anything which is artificially white in feature, white sugar, white maida and white rice.

Most people who have high salt in their body will have the characteristic feature of having a liking for both ice cold as well as boiling beverages.
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Mega Press Conference on the occasion of Doctor’s Day, held at Jabalpur.
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TRENDO 2015
The 3rd Annual meeting of the Endocrine Society of Tamil Nadu and Puducherry will be held in Kodaikanal on 11th and 12th of July 2015. TRENDO 2015 is proposed to address latest updates, emerging concepts, clinical applications and controversies in diabetes, thyroid disorders, gonadal problems, pituitary disorders, metabolic bone disease and adrenal diseases.
Cardiology eMedinewS
  • The largest-of-its-kind study confirms race and gender-related disparities exist in care for patients who have recently been diagnosed with atrial fibrillation (AF). The study is published in the July edition of HeartRhythm.
  • Educating and training the public on how to recognize and respond to cardiac arrest with the goal of increasing bystander CPR is a significant strategy to increase survival, suggests a new report from the Institute of Medicine.
Pediatrics eMedinewS
  • The first clinical trial of a new treatment, DFMO, an investigational agent, for children suffering from neuroblastoma showed minimal side effects with long-term survival. The findings are published in PLOS One.
  • According to a study, published in the American Journal of Health Promotion, found that children who regularly participated in structured sports were better at following instructions and remaining focused in the classroom than their peers by the time they reached fourth grade.
Dr KK Spiritual Blog
Do Your Duty with Discipline and Devotion: The Triad Represents Rama, Lakshmana and Hanumana

"Vasudhaiva kutumbakam" (the whole world is one family) and "Ekam Sat Viprah Bahudavanti" (truth is one but the wise call it by various names) are two basic statements, which come from the ancient Rig Veda and form the fundamentals of Vedic philosophy.

One should do one’s duty with devotion and discipline. This principle can be remembered as the principle of three Ds.

In daily routine, one should remember the purpose for which one is born, which is to fulfill Dharma (duty), Artha (wealth), Kama (desire) and Moksha (liberation). To achieve them, one needs to follow the four Fs: (i) Follow the teacher (ii) Face the negative devils of the mind (iii) Fight till the end, and (iv) Finish at the goal.

The essence of Bhagwad Gita can be summarized in one shloka (Chapter 2.48) where Krishna says to Arjuna “yogastha kuru karmani”, which means ‘concentrate on actions’ (do all actions while remaining in yoga). He further says that one should take success and failure in the same stride. (yogastha: = steadfast in yoga, kuru = perform, karmani = duties or action).

To acquire spiritual health, one should follow three Ss which are: (i) Satsang (company of good people) (ii) Sadhna (hard work), and (iii) Sanskar (good deeds). Adi Shankaracharya in Bhaj Govindam describes them as Satnam or Simran (bhakti, or reciting the name of their God), Satsang (company of good people) and Seva (good karmas).

Before doing any work, one should follow the principles of three Hs: (i) listen with the Head, (ii) follow the Heart to choose one of the choices and (iii) order the Hands to take an action.

The ABCs of a good professional are Availability, Behavior and Competence. Competence comes last; the first is the availability of the professional.

An action should be based on Truth; it should be coming from consciousness and should end in internal bliss. Various Vedic literatures have termed this triad by different names like satha, chitha, ananda, and satyam, shivam sundaram.
Make Sure
Situation:A 20–year–old college student complained of dysuria, frequency and pyuria.
Reaction: Oh my God! Why did you not advise macrolide?
Lesson: Make sure to remember that macrolides are very effective against E. coli, S. saprophyticus and C. trachomatis infection.
Dr Good Dr Bad
Situation: A patient with diabetes was found to have high insulin levels.
Dr. Bad: It has no significance.
Dr. Good: It is related to cognitive dysfunction.
Lesson: Results of a prospective Japanese study suggest that higher insulin and glycohemoglobin levels may be associated with diabetes-related cognitive dysfunction in the elderly patients (Dement Geriatr Cogn Dis Extra. 2011 Jan-Dec; 1(1): 1–9).

(Copyright IJCP)
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
Do not use 2 pin electrical appliances: they can be dangerous

With the onset of monsoon and the continuing use of electrical equipments, deaths due to electrocution are quite common. About 3–5 persons die due to electric shock everyday in any major city during the monsoon months. Most deaths due to electric shock could be attributed to lack of awareness regarding the basic principles of electrical systems and callousness while handling electrical equipment, said Padma Shri, Dr B C Roy & DST National Science Communication Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and Hony Secretary General, Indian Medical Association.

The public should not only know the safety principles but also the inherent dangers of handling electrical equipment, along with preventive measures to reduce mishaps and methods to revive a person, who has suffered an electric shock. Like fire, electricity is a good servant but a bad master. If used properly it is a boon in every day’s life and if manhandled can cause death.

The most important education required is regarding the proper use of earthing. Earthing can be procured either from the city source or made indigenously at home by digging a big hole. Earthing is a thick wire attached to the top hole of a 3–pin electrical socket. Earthing leads are, by international convention, kept green so that there should be no difficulty in identifying it and pointing it out.

People need to be familiarized with the colors used on the insulation; green is for earthing, black for neutral and red for live wire. Normal electricity is generated when the live wire is connected to the neutral wire. Earth wire is a safety mechanism to remove leakage of the electrical current. Live with earth wire will also give the electrical current but not when the earth wire is connected to the neutral wire.

Earthing is a safety outlet, which allows leaking electricity to be conducted away harmlessly and not through the body. Earthing needs to be checked every 6 months because it deteriorates with time and weather, particularly during the rainy season. A check can be carried out using an ordinary tester on the body of the appliance.

A tester or a test lamp can easily check that earthing is proper. One can light bulb with live and earth wire. If the bulb fails to light while connecting live and earth socket it means a defective earthing. People tend to take earthing lightly and often misuse it. Live and earth wires are sometimes untied together for temporary connection, which can be dangerous to life.

Following are few general precautions, Dos and Don’ts, which people should take to prevent electrical hazards:
 
  • Make sure that you have proper earthing connection in the house.
  • Always remember the green wire. Without it, do not use any electrical appliances, especially if it is touching any water surface. Water enhances conductivity; extra precautions therefore should be taken, while handling appliances, under wet conditions.
  • Two–pin plugs with no earthing arrangements should not be used and in fact should be banned.
  • While using 3–pin plugs, make sure that all 3 wires are connected and the pins are not defective.
  • Do not use matchsticks to hold wires in the socket.
  • Do not touch any wire without ensuring that power supply is switched off.
  • Do not use the earth wire to replace the neutral wire.
  • All joint wires should be properly insulated with proper insulated tapes and not with sello tape or Band–Aids.
  • Before using geyser water, it should be switched off.
  • Do not use heater plates with exposed wire for cooking purpose.
  • Use dry rubber slipper at home.
  • Use mini circuit breaker (MCB) and earth leak circuit breaker (ELCB) facilities at home.
  • Metallic electrical appliance should not be kept near a water tap.
  • Using rubber mats and desert coolers by using rubber leggings in the stand can insulate electrical appliance.
  • Use only recommended resistance wires and fuses.
  • Earthing should be checked every 6 months.
  • Any ordinary tester can check the presence of leaking electricity.
  • Wrap cloth around the handle of the refrigerator
  • Read the set of instructions attached with every electrical appliance.
Accidental electric deaths occur more often in India due to the use of 220 V than in the US, where 110V is used. AC current is more dangerous than DC. An AC current of more than 10 MA causes tetanic muscular contractions making it impossible for a hand grasping an energized object, to free itself.

In case of electrocution, proper resuscitation is necessary. The mains should be switched off or wires disconnected using a wooden material and cardiopulmonary resuscitation should be started immediately. In a clinically dead patient, a thump in the center of the chest from a distance of one foot may alone revive a person.

In severe electrocution, clinical deaths occur within 4–5 min. Therefore time to act is limited. Do not wait for the victim to be taken to the hospital. Act there and then.
eIMA News
Dr BC Roy Awards not declared even this year
The last Dr BC Roy Awards were given in 2008. The Awards are given by BC Roy Memorial Fund and the Award Committee is headed by Hon’ble Prime Minister or his Nominee.

As per reliable sources the Nominee may be appointed in the next one or two months. If that happens the seven years Awards may be declared in the next few months.

IMA have already written to Hon’ble Prime Minister to expedite the process
News
  • Walking just two hours a week can cut your chances of dying early from cardiovascular disease by up to 53%.
  • Worldwide, there are around 35 million people living with HIV (human immunodeficiency virus), with the majority of these residing in Sub-Saharan Africa.
  • According to the World Health Organization (WHO), there has been a significant increase in the number of people with HIV receiving antiretroviral therapy (ART) in recent years, with more than 2 million individuals newly enrolled to the treatment in 2013.
  • WHO say the likelihood of an HIV-infected individual transmitting the virus to their partner is reduced by 96% if they are receiving the treatment.
Notices to govt., police over attack on doctors
Source: The Hindu, New Delhi, July 5, 2015, Staff Reporter

Taking cognizance of incidents of attacks and assault on city doctors, the Delhi High Court served a notice to the Aam Aadmi Party-led Delhi government and Delhi Police this past week, asking them to state the steps taken to ensure the safety of doctors. The court also asked them to specify the action taken in each incident that had come to light.

“There are several instances where doctors were beaten and manhandled. Have you registered any FIR?” said the court of Chief Justice G. Rohini and Justice Jayant Nath during the hearing.

The directions were issued after a Public Interest Litigation was filed by the Indian Medical Association (Delhi North Zone). The petition stated that the government and police had failed to ensure the safety of doctors. It added that this was not just significant for the medical community, but also the public at large.

“If threat to doctors leads to their shortage in government hospitals, the public will be disadvantaged immensely. It is a matter of record that doctors were strained to go on strike in the past week for inaction on the part of the respondents in assuring their safety,” the petition stated.

A recent two-day strike by doctors from nearly 20 hospitals in the city had badly affected health services in the Capital. The protestors had various demands, including security for doctors.
News
  • A new study published in the American Journal of Medical Genetics: Neuropsychiatric Genetics (Part B) suggests that people with light-colored eyes are more likely to be alcohol dependent than those with brown eyes, with blue-eyed individuals at highest risk.
  • A new study reported that a single dose of FK506, an anti-rejection drug typically used after organ transplantation, might be able to prevent inflammation of the pancreas due to exposure to an X-ray dye during a common procedure to treat gallstones. The study is published online in Gastroenterology.
  • Women with fibromyalgia are more sedentary and less physically active than their counterparts without fibromyalgia, but neither group meets recommended levels of physical activity, suggests new research published in Arthritis and Rheumatology.
  • Body size should not be a major factor influencing decisions about dose reduction in women with ovarian cancer, suggested a retrospective analysis of an administrative database published online in JAMA Oncology.
  • The largest international study to compare brain volumes of people with major depression to those of healthy people finds the former tend to have a significantly smaller hippocampus. The findings are published in the journal Molecular Psychiatry.
Quote of the Day
The real opportunity for success lies within the person and not in the job. Zig Ziglar
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Reader Response
Dear Sir, You are doing fabulous service to mankind. Regards: Dr Sikha
Media
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Inspirational Story
Don’t change the world

Once upon a time, there was a king who ruled a prosperous country. One day, he went for a trip to some distant areas of his country. When he returned, he complained that his feet were very painful, because it was the first time that he went for such a long trip, and the road that he went through was very rough and stony. He then ordered his people to cover every road of the entire country with leather. Definitely, this would need thousands of cows’ skin, and would cost a huge amount of money.

Then one of his wise servants dared himself to tell the king, "Why do you have to spend that unnecessary amount of money? Why don’t you just cut a little piece of leather to cover your feet?"

The king was surprised, but he later agreed to his suggestion, to make a "shoe" for himself.

There is actually a valuable lesson of life in this story: to make this world a happy place to live, you better change yourself – your heart; and not the world…
Wellness Blog
Eat 20 almonds or 15 cashews or 30 peanuts every day

People who ate a 1–ounce serving of nuts each day showed a 20 percent reduced risk of dying from any cause over three decades, compared to those who didn’t eat the tasty snacks, as shown a study published in the Nov. 21 issue of the New England Journal of Medicine by Dr. Charles Fuchs, director of the Gastrointestinal Cancer Center at the Dana–Farber Cancer Institute in Boston.

Prior studies suggest health benefits like a lower risk of heart disease and type 2 diabetes and lower cholesterol, among other health outcomes. Nuts are nutrient-dense foods. They contain unsaturated fatty acids, fiber, vitamins, minerals and antioxidants.

One–ounce serving was equal to about 16 to 24 almonds, 16 to 18 cashews or 30 to 35 peanuts.
Events
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eMedi Quiz
Which one of the following conditions may lead to exudative pleural effusion

1. Cirrhosis.
2. Nephrotic syndrome.
3. Congestive heart failure.
4. Bronchogenic carcinoma.

Yesterday’s Mind Teaser: An anxious mother brought her 4 year old daughter to the pediatrician. The girl was passing loose bulky stools for the past 20 days. This was often associated with pain in abdomen. The pediatrician ordered the stool examination which showed the following organisms. Identify the organism:

1. Entamoeba histolytica
2. Giardia lamblia
3. Cryptosporidium
4. E. coli

Answer for yesterday’s Mind Teaser:2. Giardia lamblia

Correct Answers received from: Dr S C Gupta, Dr. G. Madhusudhan, Dr Shangarpawar, Daivadheenam Jella, Dr K V Sarma, Dr Poonam Chablani, Dr Jainendra Upadhyay

Answer for 5th July Mind Teaser: 2. Whole blood

Correct Answers received: : Dr. G. Madhusudhan, Dr Avtar Krishan
IMA Humor
Price you pay for being good

Three men were waiting to go to heaven. St Peter was at the gate and said, "However good you were to your wife that is the vehicle you will get in heaven".

The first guy comes up to the gate and says, "I never, ever cheated on my wife and I love her". So St. Peter gives him a Rolls Royce.

The next man comes up and says, "I cheated on my wife a little but I still love her." He gets a mustang and drives off into heaven.

The next guy came up and said, "I cheated on my wife a lot". He gets a scooter.

Next day the guy that got the scooter was riding along and he saw the guy who owned the Rolls Royce crying.

He asked, "Why are you crying you have such a nice car?!" and the man sobbed, "My wife just went by on roller skates".
Rabies News (Dr A K Gupta)
Can the vaccine be injected in gluteal region?

Rabies vaccine must not be administered in gluteal region as the gluteal fat may retard vaccine absorption resulting in delayed and lower seroconversion.
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