Daily eMedinewS

19th May 2012, Saturday

Kalyug and Mosquitoes

As we are moving deeper and deeper into Kalyuga, we see that mosquito–related diseases are on the rise whether it is Dengue, Chikungunya or Malaria. As per Shrimad Bhagwad, Pralaya and Mahapralaya are linked to global warming and as global warming progresses, mosquito–related illnesses will only increase

There is one more lesson from mosquitoes growing and their menace in kalyuga and that is that even a very small insect like mosquito can kill a human being. Therefore, never estimate anyone as small in Kalyuga.

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Dr KK Aggarwal

Photographer’s awareness saved girl’s vision

When she turned nine months old, the family decided to have her naming ceremony. On that occasion they went to a photo studio in Gubbi near Tumkur, their native place. The photographer, Lingaraju, while clicking the photos noticed a white spot in Gayathri’s eye, but did not mistake it for any kind of omen. He simply advised the parents to take the child to an eye specialist and investigate if she had retinoblastoma or eye cancer. They will forever be thankful to Lingaraju, because his alertness saved their daughter’s eyes. But the couple did not know of the impending danger to their child’s life. On a second occasion, when Pramila found a job and was enrolled for an ESI (employee state insurance) scheme, the photographer, while clicking the family’s photo, again noticed the white spot in Gayathri’s eye and suggested to the couple to check if the child was suffering from eye cancer. Taking the second advice seriously, the couple took the child to Narayana Nethralaya, where she was detected with retinoblastoma. “Retinoblastoma is a silent tumour and is most often detected too late to save the eye. Gayathri’s tumour was detected in the third stage and luckily we could save her eyes. She is now 18 months old. In India, every year we get about 1,500 new cases of rentiblastoma and 80% of them are curable. It generally takes about 1–2 years to treat the cancer completely,” said Dr Ashwin Mallipatna, paediatric ophthalmologist, In–charge of Retinoblastoma Service, Narayana Nethralaya. (Source: TOI, May 16, 2012)

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Centre To Double Medical Seats By 2021

The Centre is planning to double the number of medical seats in undergraduate and postgraduate courses to achieve a target of 80,000 MBBS and 45,000 PG seats by 2021, health ministry officials said. The officials said the plan has been mooted to ensure a doctor–patient ratio of 1:1,000 against the current fraction of 1:2,000.The ministry of health and family welfare is targeting additional 38,431 seats in the MBBS and 22,806 seats in the PG streams by 2021, representing a rise of 92.45 per cent and 102.75 per cent respectively. The target is 80,000 MBBS seats and 45,000 PG seats by 2021, the officials said at the meeting of Parliamentary Consultative Committee on health chaired by health minister Ghulam Nabi Azad here on Monday. The meeting was called to discuss the scenario of medical infrastructure. At present, there are 41,569 MBBS seats in the 335 medical colleges across India and 22,194 PG seats. However, most of these seats and medical colleges are concentrated in the southern and western states with the central Indian states of Madhya Pradesh and Chhattisgarh barely getting any share in medical infrastructure. Ministry’s latest data shows that 66 per cent of the 335 medical colleges and 69 per cent of the current MBBS seats are located at present in the Southern and Western states, including Kerala, Karnataka, Andhra Pradesh, Tamil Nadu, Maharashtra, Gujarat, Rajasthan and Goa. Eastern India, comprising Bihar and West Bengal, which feature among the five most populous states, have 10 per cent just 9 per cent MBBS seats. (Source: Deccan Chronicle, May 15, 2012)

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

(Contributed by Dr Monica and Brahm Vasudev)

Look away from needle prick to lessen pain, suggests study

A person’s expectations about pain might affect how much discomfort he or she experiences, according to a study published online April 17 and in the May print issue of Pain. (Source: Medscape)

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Coffee linked to lower death risk

Java lovers, take heart. A large prospective study suggests that – far from being bad for your health – that steaming cuppa is actually associated with a lower risk of death. (Source: Medpage Today)

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More evidence that physical activity protects the aging brain

New data from the Rush Memory and Aging Project provide more evidence that staying physically active may protect the aging brain from Alzheimer’s disease (AD). (Source: Medscape)

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Adherence to 29 best practices improves hospital’s efficiency by 150%

NEW DELHI: A simple checklist – similar to the ones a pilot uses before take off – has been found to improve adherence to essential childbirth care practices at a hospital in south India by 150%. The checklist that includes 29 best practices was tested by the Harvard School of Public Health (HSPH) and the World Health Organization (WHO) at a hospital in Karnataka. The checklist prompted health workers to remember to complete proven practices such as hand washing, infection management, postpartum bleeding assessment and breastfeeding within an hour after birth. The results reveal that the number of essential practices performed by the hospital workers increased from an average of 10 of 29 at baseline to 25 of 29 after implementing the checklist. Nearly 300,000 maternal deaths, 3.1 million newborn deaths and 1.2 million intrapartum–related stillbirths take place in countries like India each year – the vast majority being preventable. From 2008 to 2010, HSPH and WHO developed the WHO Safe Childbirth Checklist Programme and field tested it in 10 countries, mostly in Africa and south Asia. Items on the 29–item checklist address the major causes of maternal deaths (hemorrhage, infection, obstructed labor, and hypertensive disease), intrapartum–related stillbirths, and neonatal deaths (complications of premature birth, infection, and birth asphyxia). Researchers observed the childbirth practices of healthcare workers during 499 birth events – the period from admission to discharge – prior to introducing the checklist to establish a baseline, and then compared the results with 795 birth events after implementing the checklist. The study appears in the May 16th edition of PLoS ONE. (Source: TOI, May 18, 2012)

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@DrKKAggarwal: Science of Silence http://t.co/yt0EcoJQ

@DeepakChopra: Boldness is the ability to step outside boundaries created by fear and insecurity. Transcend your own limitations

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

Science of Silence

The treatment of grief is either to go into silence for some time, introspect and let the consciousness take its own route or to go opposite and prescribe narration exposure therapy which is well described in our traditional Indian mourning period under the head Daily Baithak for 4 or 13 days.

In Baithak, the grieved person is supposed to repeatedly talk about the grief till he or she is de–stressed.

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(Dr Kaberi Banerjee, IVF expert, New Delhi)

What are the causes of intrauterine adhesions?

The most common cause of intrauterine adhesions is trauma to the uterine cavity. This may occur following dilation and curettage (D&C), an outpatient surgical procedure during which the cervix is dilated and the tissue contents of the uterus are emptied. Prolonged use of an intrauterine device (IUD), infections of the endometrium (endometritis), and surgical procedures involving the uterus (such as removal of fibroids) also may lead to the development of intrauterine adhesions.

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(Dr N K Bhatia, Medical Director, Mission Jan Jagriti Blood Bank)

Fresh frozen plasma

Description

• Pack containing the plasma separated from one whole blood donation within 6 hours of collection and then rapidly frozen to –25°C or colder. Shelf life is 12 months.
• Contains normal plasma levels of stable clotting factors, albumin and immunoglobulin
• Factor VIII level at least 70% of normal fresh plasma level (0.7 IU/ml).

Unit of issue

• Usual volume of pack is 200–300ml
• Smaller volume packs may be available for children

Infection risk

• If untreated, same as whole
• Very low risk if treated with methylene blue/ultraviolet light inactivation (see virus inactivated plasma)

Storage

• At 25°C or colder for up to one year
• Before use, should be thawed in the blood bank in water, which is between 30ºC to 37°C. Higher temperature will destroy clotting factors and proteins
• Once thawed, should be stored in a refrigerator at +2°C to 6°C

Indication

• Replacement of multiple coagulation factor deficiencies: e.g. Liver disease, warfarin (anticoagulant) overdose, depletion of coagulation factors in patients receiving large volume transfusion
• Disseminated intravascular coagulation (DIC)
• Thrombotic thrombocytopenic purpura (TTP)

Precautions

• Acute allergic reactions are not uncommon, especially with rapid infusions
• Severe life–threatening anaphylactic reactions occasionally occur
• Hypovolemia alone is not an indication for use

Dosage: Initial dose of 15ml/kg

Administration

• Must normally be ABO compatible to avoid risk of hemolysis in recipient
• No compatibility testing required
• Infuse during a standard blood administration set as soon as possible after thawing
• Labile coagulation factors rapidly degrade; use within 6 hours of thawing

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(Dr GM Singh)

To be trusted is a greater compliment than to be loved.~ George MacDonald

(Dr Arpan Gandhi and Dr Navin Dang)

Pediatric Allergy Screen, Serum

Testing for IgE antibodies may be useful to establish the diagnosis of an allergic disease and to define the allergens responsible for eliciting signs and symptoms, to confirm sensitization to particular allergens prior to beginning immunotherapy, and to investigate the specificity of allergic reactions to insect venom allergens, drugs, or chemical allergens.

Read this…………………

Nurse Josie should instruct the client to eat which of the following foods to obtain the best supply of Vitamin B12?

a. dairy products

b. ve.getables

c. Grains

d. Broccoli

Yesterday’s Mind Teaser: Which of the following represents a significant risk immediately after surgery for repair of aortic aneurysm?

a. Potential wound infection

b. Potential ineffective coping

c. Potential electrolyte balance

d. Potential alteration in renal perfusion

Answer for Yesterday’s Mind Teaser: d. Potential alteration in renal perfusion

Correct answers received from: Dr Ragavan Sivaramakrishnan Moudgalya, Yogindra Vasavada, Dr P C Das, Dr Jainendra Upadhyay, Mannalal Bhansali, Dr Chandresh Jardosh, Raju Kuppusamy, Muthumperumal Thirumalpillai, Dr Avtar Krishan, Dr Shashi Saini, Dr LC Dhoka, Dr Thakor Hitendrsinh G, Dr U Gaur.

Answer for 16th May Mind Teaser: a. High levels of low density lipid (LDL) cholesterol

Correct answers received from: Dr Amol Hartalkar, Dr RK Sahoo, yJ Vasavada , Dr BB Aggarwal, Bal Kishan Agarwal, Dr Stella Selina, Dr Sagar Tucker.

Send your answer to ijcp12@gmail.com

(Prabha Sanghi)

A woman went to her doctor’s office. She was seen by one of the new doctors, but after about 4 minutes in the examination room, she burst out screaming and ran down the hall. An older doctor stopped her and asked what the problem was, and she explained. He had her sit down and relax in another room. The older doctor marched back to the first and demanded, “What’s the matter with you? Mrs. Terry is 63 years old, she has four grown children and seven grandchildren, and you told her she was pregnant?” The new doctor smiled smugly as he continued to write on his clipboard. “Cured her hiccups though, didn’t it?”

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

What is medical treatment of chemical contamination and burn?

• In case of chemical contamination or burn injury of eye, put fluorescein drops in the eye. Burns will stain yellow.
• If there are yellow stains with fluorescein, put chloramphenicol 1% eye ointment in the eye. Put more ointment into the eye every two hours. Continue until the eye is no longer red and the sclera is white, and then for another 24 hours.
• If the pain is severe the patient may need an intramuscular injection of morphine.
• If there is no water nearby dab or gently wipe the skin and hair with cloths or paper.
• Immediately wash the affected part of the body under cold or lukewarm running water, using soap if you have some. If there is no running water use buckets of water. Do it quickly and use a lot of water. Wear gloves and an apron if needed, to protect you from splashes of chemical. Some chemicals give off vapor: be careful not to breathe it in.
• Quickly remove any of the patient’s clothes contaminated with chemical or vomit, as well as shoes and wrist watch if necessary. Speed is important. Cut the clothes off if the chemicals are very poisonous or corrosive.
• If large areas of the body are contaminated with chemical, wash the patient under a shower or a hose. Remember to clean the hair and under the fingernails, in the groin and behind the ears, if necessary.
• Continue to pour water over the patient for 10 minutes or longer if you can still see chemicals on the skin. If the skin feels sticky or soapy, wash it until the feeling disappears. This may take an hour or more.
• Make sure the water drains away freely and safely as it will have chemical in it.
• Do not rub or scrub the skin.
• Dry the skin gently with a clean, soft towel. If clothing stays stuck to the skin even after water has been poured over it, do not remove it.
• Remember that many chemicals can pass through the skin very quickly. Look for signs of poisoning.

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Public Forum (Press Release for use by the newspapers)

Heart patients beware of summer

There is a change of weather both in the politics and the arrival of summer. With the increase in the relative humidity, more and more cases of heat disorders are being reported in the city.

Dehydration can precipitate heart attack in susceptible individuals. The normal fluid requirement is 30 ml per kg weight, but it needs to be increased in the summer because of the loss of fluid from sweating. Besides water, sodium (Na) or salt is also lost. A person, therefore, needs to take more fruit during the summer period.

Not passing urine in 8 hours, dry armpits, feeling exhausted or feeling weak are the warning signals said Padma Shri and Dr B C Roy National Awardee Dr KK Aggarwal, President Heart Care Foundation of India. Dehydration can make the blood thick and precipitate heart attack in patients with uncontrolled blood pressure or diabetes.

Walking is a necessity for heart patients and the same should be continued even during peak summer but the timing should be so chosen that peak heat periods are avoided. One can walk early in the morning or late in the evening. People taking anti–allergic pills should take special precautions as they are more likely to get heat stroke.

Heat stroke is a medical emergency leading to charring of organs because of extreme internal heat. A person’s temperature may rise to more than 105°F.

Preventing summer disorders

• The most common summer disorders are dehydration, heat cramps, heat exhaustion and heat stroke on one hand and acidity, infections, diarrhea, cholera, typhoid and jaundice on the other hand.
• Heat cramps, exhaustion and stroke all result from prolonged exposure to heat but differ in the severity of the illness.
• Heat cramp is a milder form of illness where a person has weakness dehydration, and salt deficiency. The treatment is replacing fluid and salt orally.
• Heat exhaustion, on the other hand, is a relatively serious condition with fever, dehydration, weakness but presence of sweating. If not diagnosed and treated in time, with rapid fluid replacement heat exhaustion can end–up into heat stroke, where the body’s thermoregulatory mechanisms fail leading to a sudden rise in internal temperature and charring of organs and ultimate death.
• Heat stroke is a medical emergency and requires bringing down of temperature within minutes. Absence of sweating, dry armpit, not passing urine for 8 or presence of high grade fever in summer season should not be ignored and medical attention taken immediately.
• Diarrhea, cholera, typhoid and jaundice are all food– and water–borne diseases due to poor hygiene and shortage of water supply in the community. All of them can become serious if not attended in time. Of these, diarrhea and cholera are infections of small intestine and require replacing with lemon water mixed with sugar and salt. The deficiency of fluid may be up to 6 to 8 liters. A person needs to be hospitalized only if the number of loose motions is more than 12.
• For prevention of these diseases, follow the principle – Heat it, Boil it, Cook it, Peal it or Forget it.

1. Dear Sir, eMedinews is really a great source of Information. Regards:Anita

IYCNCON 2012

All are cordially invited for the 2^nd National Conference of IYCF Chapter of IAP. This conference is organized by: IYCF Chapter, MOH&FW GOI, MOWCD GOI, WHO, UNICEF, IMLEA, SDHE Trust.

The theme of the conference is: “Proper Nutrition: Defeat Malnutrition – Investing in the Future”

Venue: India Habitat Centre, Lodhi Road, New Delhi – 110 003.

Date: 5th Aug 2012

For further details contact:

Conference Secretariat: Dr. Balraj Yadav, E–Mail: drbalraj@ymail.com, drvisheshkumar@gmail.com,

Ph: +91.124.2223836, Mobile: +91.9811108230

Dil Ka Darbar

September 23, 2012 at 9:00 AM – 6:00 PM

Tal Katora Indoor Stadium, Connaught Place, New Delhi, 110001

http://www.heartcarefoundation.org

A non stop question answer session between all the top cardiologists of the NCR region and the mass public. Event will be promoted through hoardings, our publications and the press. Public health discussions

Dr Veena Aggarwal, Dr Arpan Gandhi, Dr Aru Handa, Dr Ashish Verma, Dr A K Gupta, Dr Brahm Vasudev, Dr GM Singh, Dr Jitendra Ingole, Dr Kaberi Banerjee (banerjee.kaberi@gmail.com), Dr Monica Vasudev, Dr MC Gupta, Dr Neelam Mohan (drneelam@yahoo.com), Dr Navin Dang, Dr Pawan Gupta(drpawangupta2006@yahoo.com), Dr Parveen Bhatia, (bhatiaglobal@gmail.com), Dr Prabha Sanghi, Dr Prachi Garg, Rajat Bhatnagar (http://www.isfdistribution.com), Dr. Rajiv Parakh, Dr Sudhir Gupta