July 1  2015, Wednesday
Today is Doctor's Day

IMA Doctor's Day Awards on July 1st 2015
Dr KK AggarwalDr Pillai"Doctor of the Year Award 2015"
  1. Dr Mohamed Shafi, Trivandrum: IMA Life member with high academic qualification in Public Health, Ethics and Bioethics. Dr Shafi was involved in Polio Eradication activities in some of the most difficult areas of Bihar, especially the Kosi flood affected districts, as Surveillance officer (WHO). While in Médecins Sans Frontières (MSF, Spain) - Doctors without Borders, he was the key coordinator for the largest treatment Projects on Kala Azar in India, which led to the emergence of a new treatment protocol for the disease in the country now. He supported the Tripura Government during the period of a large meningococcal meningitis outbreak in 2010, in arranging training to Doctors as well as co-coordinating internationally to arrange thousands of units of vaccines from the international pool, at a time when meningococcal vaccine was short in India. He was Medical Consultant WHO TB control, conducted social survey in Bihar on Health status, National Polio Surveillance program, several projects - social and academic in branch and state level (save girl child, girl schools adopted for safe disposal of napkins, Rural health Activities, implementing Patient care fund, carrying out all IMA Projects and Propagating national Schemes)
  2. Dr Anoop Varma, Raipur: IMAA Life Member, Past State president, Team leader of IMA Nepal Disaster Relief, School health program, as ORS ambassador, rural health activities promoting all IMA projects. Several reliefs Camps
  3. Dr Jayant Navarange, Maharashtra, Pune: IMA life member, State president and Secretary, Chairperson of medicolegal cell Pune branch, several articles on health and health awareness leaflets for public, president of IAP Pune. Working with orphanages for years for their betterment and Health care. Conducted several rural health programs and propagated the Save Girl Child slogan. He is propagating National projects and schemes.
  4. Dr. Joseph Benevan, KuthuParamba: Life member, held various posts in IMA and provided leadership in Rural and public health, tribal settlement public health activity, promoting all IMA schemes of state and National. He is instrumental in modernizing the IMA IMAGE project in biomedical waste disposal. He is working as joint secretary for 6years and Secretary IMAGE for 4 years. Does charity services, especially in Tribal colony Attapadi; conducted Mega Medical Camp at Manthurithi Panchayat, Palakkad, in which 54 doctors participated and 2000 tribal people were screened for cancer. Regular medical camps and health awareness camps in Adivasi colony at Kannur as part of Aao Gaon Chalein project of IMA. Holds classes against drug abuse, diabetic detection to prevent diabetic blindness and similar projects of branch, State and National IMA.
There were a total of 32 applicants including till 26th June; of these, 10 were not eligible. Twelve members were shortlisted from 22 eligible members for consideration of Award of the Year 2015. Four were finalized for the awards.

IMA Life Time Achievement Award

Only two senior candidates were eligible for consideration for this award.
  1. Dr Harish Grover, New Delhi, Past Hon. Secretary General IMA 1982-1986
  2. Dr Vijay Agarwal, Noida, Secretary Delhi IMA in 1976
The scrutinizing committee feels that nobody is eligible to award the Millennium award.

The list was scrutinized with the help of Dr VCV Pillai, Past National President IMA. After the awards committee report, the final list was approved by the National President Dr Marthanda Pillai.

Prof. Dr A Marthanda Pillai                                                                                           Prof. Dr K K Aggarwal
National President, IMA                                                                                               Honorary Secretary General, IMA
IMA TSK organized a CME on 27th June on “Osteoarthritis of Knee Joint”
  • Overweight and obese people with type 2 diabetes may feel better after a meal if they start it off with vegetables or proteins and end with the carbohydrates, suggests a new study published in Diabetes Care.
  • A novel investigational implanted nerve stimulator device continues to alleviate pain at 2 years in two thirds of patients with refractory cluster headache, suggests new data presented at the American Headache Society (AHS) 57th Annual Scientific Meeting.
  • Combining brain stimulation with a challenging motor training task may improve poststroke rehabilitation, suggests a new randomized, double-blind, crossover study presented at the first Congress of the European Academy of Neurology (EAN).
  • A week-long course of accelerated partial breast irradiation (APBI) after lumpectomy led to low rates of breast cancer recurrence and a 10-year survival of 96%, suggested a multi-institutional study published online in Annals of Surgical Oncology.
  • Particulate matter from gasoline engines is harmful to our airways, irrespective of whether the engines are a bit older or comply with recent standards, suggests new research published in the Nature Scientific Reports specialist magazine.
Kodaikanal on 11th and 12th of July 2015.

Vanakkam ! Welcome to Trendo 2015

Dear All, On behalf of the organizing committee of TRENDO 2015, we take immense pleasure in inviting you to attend TRENDO 2015, 3rd Annual meeting of the Endocrine Society of Tamilnadu and Puducherry. This much-awaited conference after the grand success of TRENDO 2014, 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
  • A simple, five-point score, the DROP score, appears to predict the likelihood of postural hypotension in elderly people, suggests new research presented at the European Society of Hypertension (ESH) 2015 Scientific Sessions.
  • New research presented at the European Heart Rhythm Association (EHRA) EUROPACE-CARDIOSTIM 2015 meeting suggests that women are being treated unfairly when it comes to receiving cardiac implantable electronic devices, which is a cause of concern since they actually have higher survival rates than men after implantation of certain device types.
Pediatrics eMedinewS
  • Updated recommendations published online June 26 by the American College of Obstetricians and Gynecologists suggest a key role of obstetrician/gynecologists and other healthcare providers in providing patients and their parents with information on the benefits and safety of the human papillomavirus (HPV) vaccine and in encouraging adolescents to receive the HPV immunization.
  • New recommendations from the American Academy of Pediatrics (AAP) for preventing childhood obesity published in the journal Pediatrics, lay out how pediatricians can be more proactive in helping families nip excess weight gain in the bud.
    • Children's diets should be rich in low-calorie foods.
    • Family meals should be eaten at a table without distractions such as TV.
    • Children should be encouraged not to skip meals, especially breakfast.
    • Screen time should be limited to 2 hours or less per day, both because it's sedentary and it exposes kids to food advertising. Mindless snacking in front of the TV should be avoided.
    • Children should get their age-appropriate amounts of sleep per day.
Dr KK Spiritual Blog
Relieve stress by changing the interpretation

Stress is the reaction of the body or the mind to the interpretation of a known situation. Stress management, therefore, involves either changing the situation, changing the interpretation or taming the body the yogic way in such a way that stress does not affect the body.

Every situation has two sides. Change of interpretation means looking at the other side of the situation. It is something like half glass of water, which can be interpreted either as half empty or half full.

Studies have shown that anger, hostility and aggression are the new risk factors for heart disease. It has been shown that even recall of anger can precipitate a heart attack.

Many studies have shown that when doctors talk positive in front of unconscious patients in ICU, their outcome is better than those if doctors talk negative.

The best way to practice spiritual medicine is to experience silence in the thoughts, speech and action.

Simply walking in the nature with silence in the mind and experiencing the sounds of nature can be as effective as 20 minutes of meditation. Twenty minutes of meditation provides the same physiological parameters as that of 7 hours of deep sleep.
Beneficiaries of Sameer Malik Heart Care Foundation Fund
Make Sure
Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2 trial suggest that this intervention is much better than thrombolytic therapy in such patients.
Dr Good Dr Bad
Situation: An asymptomatic diabetic patient came for a cardiac checkup.
Dr. Bad: No Echo is required.
Dr. Good: Get Echo done for diastolic dysfunction.
Lesson: A case-control prospective study done over one year has shown high incidence of diastolic dysfunction in asymptomatic diabetic subjects and, this finding was correlated with the duration of diabetes, HbA1c levels, obesity indices and diabetic microangiopathies. Early diagnosis and institution of treatment will reduce morbidity and improve the outcomes, and prevent future heart failure (J Cardiovasc Dis Res. 2011 Oct;2(4):213-22).

(Copyright IJCP)
eMedinewS Humor
The Anesthesiologist

Jill received a bill from the hospital for her recent surgery, and was astonished to see a $900 fee for the anesthesiologist. She called his office to demand an explanation.

"Is this some kind of mistake?" Jill asked when she got the doctor on the phone.

"No, not at all," the doctor said calmly.

"Well," said Jill, "that’s awfully costly for knocking someone out."

"Not at all," replied the doctor. "I knock you out for free. The 900 dollars is for bringing you back around."
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
Doctors must follow etiquettes to facilitate better doctor–patient relationship

A good doctor-patient relationship forms the heart of practice of medicine. And when this bond is breached, it leads to legal disputes between the doctor and his/her patients. Proper communication is the key to creating a good interpersonal relationship.

On the occasion of Doctors’ Day, 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 said that doctors should observe certain etiquettes, whenever a patient comes to them for consultation. He said doctors should follow the five principles of AIDET to improve doctor-patient relationship.
  1. Acknowledge: This means that whenever a patient comes to you greet him, call them by his/her name.
  2. Introduce: Introduce yourself or any other member of your staff to the patient and what will be doing for the patient.
  3. Duration: Keep your patient informed about for how long the treatment would continue or, any waiting time.
  4. Explain: Always tell your patients about the diagnosis, the tests or procedures in terms that they are able to understand. This is the concept of informed consent.
  5. Thank you: Thank your patient. Doing this will develop trust and respect in the patient for you as his/her doctor.
eIMA News
  • Indian Pharmacist Association (IPA) has written to the Drugs Controller General of India (DCGI) opposing online pharmacies in India. The IPA’s chief concern is that online pharmacies are in contravention of the Drugs and Cosmetics Act which states that drugs should be dispensed by registered pharmacists. Some of the concerns raised by the IPA include: – As per Section 42 of Pharmacy Act “Only Pharmacist can dispense medicine on the prescription of a doctor.” And whoever contravenes these provision is punishable with imprisonment.
  • GN Singh, the Drug Controller General of India (DCGI) has said e-commerce companies will not be allowed to sell prescription drugs for now. Singh said the government has already begun a consultation process which will eventually pave the way for consumers to buy their prescription drugs from e-tailers, but that's not before a proper system and regulations have been put in place. (CNBC)
  • The American Heart Association/American Stroke Association recommend that stent retriever thrombectomy should be performed for selected stroke patients at specialized centers after tissue plasminogen activator (tPA).
  • A week-long course of accelerated partial breast irradiation (APBI) after lumpectomy led to low rates of breast cancer recurrence and a 10-year survival of 96%, investigators in a multi-institutional study reported. (Annals in Surgical Oncology)
  • NIH Study: In patients with intra-abdominal infections who had undergone an adequate source-control procedure, the outcomes after fixed-duration antibiotic therapy (approximately 4 days) were similar to those after a longer course of antibiotics (approximately 8 days) that extended until after the resolution of physiological abnormalities.
  • Medical negligence: Principles of res ipsa loquitur have been made applicable in the case of medical negligence.
    • Where a patient sustained a burn from a high frequency electrical current used for electric coagulation of the blood (see Clarke v. Warboys The Times, 18-3-1952);
    • Where gangrene developed in the claimant s arm following an intramuscular injection (see Cavan v. Wilcox ((1973) 44 DLR 3d 42));
    • 126. In Nizam Institute of Medical Sciences v. Prasanth S. Dhananka and others, (2009 (7) SCALE 407) : (2009 AIR SCW 3563) this Court held as under:- "32.We are also cognizant of the fact that in a case involving medical negligence, once the initial burden has been discharged by the complainant by making out a case of negligence on the part of the hospital or the doctor concerned, the onus then shifts on to the hospital or to the attending doctors and it is for the hospital to satisfy the Court that there was no lack of care or diligence.
  • Child sexual abuse: First aid and medical examination: If an offence has been committed, then the victim shall be provided first aid or medical treatment free of cost by all hospitals (public and private). (IPC 357 (c) Cr. PC) * Even if an offence committed on a child under any section of POCSO Act, 2012 has not been registered at a police station, the medical examination of the child shall be conducted in accordance with S.164 A Cr.PC. (S. 27 (1), POCSO Act, 2012) Within 24 hours of receiving information of an offence under POCSO Act, 2012 or rape under IPC, it is mandatory for the Police to send the victim for medical examination to a registered medical practitioner. (S. 164A, Cr. P.C.)
Realistic health policy

It has called for a realistic health policy from the government and increasing the allocation to health to at least 2.5 per cent of the GDP in the union budget. (The Hindu)

Make health a fundamental right

Dr. R.V.S. Surendran, State president and Dr. C.N. Raja, Honorary State Secretary of the Tamil Nadu IMA State branch have demanded that the Right to Health be made a fundamental right. The association has directed doctors to participate in the Swachh Bharat Mission, and asked its members to take a pledge reinstating their commitment towards the healthcare of the country. (The Hindu)

Four-day-old baby dies in Mangalore; parents blame doctor’s negligence: The death of a newborn created a commotion with the relatives alleging doctors of negligence at Government Lady Goschen hospital, Mangalore, India.

UNICEF workshop against child sexual abuse

Workshop on child sexual abuse organised by UNICEF, IMA

Lack of awareness of provisions of the Protection Of Children against Sexual Offences (POCSO) Act, 2012, has been a major hindrance to the prevention of child sexual abuse cases, medical practitioners who handle such cases say. At the south region workshop on child sexual abuse organised jointly by the UNICEF and the Indian Medical Association (IMA) here on Sunday, experts said there were several misconceptions that obstructed the propagation of facts regarding such instances of abuse.“Numerous children, irrespective of their gender, are subjected to abuse across the country. According to unofficial studies, nearly 70 per cent of the children have been exploited at least once in the State. Many such cases involve the victim’s relatives being the perpetrators of the crime. However, many cases, especially those involving boys, have never been reported. This is mainly owing to social and cultural attitudes, and the fear of being discriminated against by society. Covering up such instances only serves to encourage the criminals to repeat such acts,” an expert said. (The Hindu)

Eight laws

IMA secretary general K.K. Aggarwal said there were eight laws that were implemented in the country to prevent the exploitation of children. Such cases were being considered as medico-legal emergencies that required immediate attention of medical practitioners and enforcers of law and order. With doctors being required to examine victims, the documentation of facts and findings had a vital role in the cases.

Training given

Inaugurating the workshop, IMA national president A. Marthanda Pillai said 500 doctors representing psychiatry, forensics, paediatric, and gynaecology departments had been imparted training as part of similar programmes organised across the country in association with UNICEF. These practitioners would later conduct training programmes in educational institutions and other places to spread awareness of the issue. IMA State unit president Sreejith N. Kumar spoke.
Inspirational Story
Look Fear in the Face

Look fear in the face. Be brave and bold. Don’t be scared of the unknown. Accept your own wrong doings as an opportunity to search deep within your soul. This way, you can't blame others for your problems.

Be strong, admit defeat and always stand tall with dignity and pride. Allow your tribulations to become your guide for new found wisdom. Don't look back with regret; move forward with positive thoughts about the good and bad.

Be slow to speak and listen openly to what others have to say with respect. Remember you have a choice to make. Live negative or positive; the choice is only dependent upon you. You are sent to this world for a reason; a gift to others and remember always you have a special purpose so never give up but move straight ahead with love, peace, forgiveness, and strength!
Quote of the Day
A good book should leave you... slightly exhausted at the end. You live several lives while reading it. William Styron
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Reader Response
Sir, Greetings from IMA Manipur State Branch, as per your directive, we organized a mega blood donation camp on Sunday the 28th of June, 2015 at Dept. of Immunohaematology and Blood Transfusion, Regional Institute of Medical Sciences, Imphal; 118 donors turned up, out of which, 108 donated blood. Participants included IMA members, medical students, civilians, security personnel of Manipur Home Affairs Dept. and CRPF M/N-Sector. This was organized as a part of the observation of Doctors’ Day on 1st of July. With regards: Dr Ng Arunkumar Singh.
eMedi Quiz
The correct sequence of cell cycle is:

1. G0-G1-S-G2-M.
2 .G0-G1-G2-S-M.
3 .G0-M-G2-S-G1.
4 .G0-G1-S-M-G2.

Yesterday’s Mind Teaser: All of the following are the electrocardiographic features of severe hyperkalemia except.

1. Peaked T waves.
2. Presence of U waves.
3. Sine wave pattern.
4. Loss of P waves.

Answer for yesterday’s Mind Teaser: 2. Presence of U waves.

Correct Answers received from: Dr Bitaan Sen & Dr Jayashree Sen, Dr Poonam Chablani, Dr A P Bhatia, Dr K V Sarma, Dr N K Mohanty, Dr K C Sharma, Dr Sharavana, Dr B R Bhatnagar, Dr Pandit Hantodkar.

Answer for 27th June Mind Teaser: 1. Clostridium tetani.

Correct Answers received: Dr Jainendra Upadhyay, Dr Poonam Chablani, Dr Bitaan Sen & Dr Jayashree Sen, Dr K Raju, Dr G Madhusudhan, Dr Pravin H Patel.
Wellness Blog
  • Malaria is transmitted by the bite of a female Anopheles mosquito.
  • The malaria mosquito bites mainly between dusk and dawn. While, the dengue mosquito bites during the day.
  • Malaria can also be transmitted by blood transfusion by sharing of contaminated needles.
  • Bed nets are good against malaria as major malarial vectors bite during the night.
  • The behavior of mosquitoes may differ. Some may prefer to rest indoors and feed indoors in the night. Some may prefer to rest and feed outdoors earlier in the day.
  • Preventive therapy of malaria can be instituted in pregnancy in high risk areas.
  • The malarial mosquito feeds every third day compared to dengue mosquito, which feeds three times a day.
  • Malarial fever presents with chills, especially during afternoon.
  • Spraying of the indoor residential walls and ceiling is effective against mosquitoes.
  • DDT is widely used as indoor residential spraying.
  • DDT should not be applied more than once or twice early in the walls.
  • Mosquito contact with DDT surface would generally save from lethal exposure outside the house.
  • Public must know that spray may require furniture rearrangement. Walls may become streaked with chemical treatment and residual odor from DDT.
  • The other alternative is malathion spray.
Rabies News (Dr A K Gupta)
If for some reason, IDRV cannot be given in deltoid region, what are the alternative sites?

IDRV can be given in deltoid region, suprascapular, anterior abdominal wall and the upper part of thigh.
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