July 26  2015, Sunday
How toprevent arthritisfromslowingyou down
Dr KK Aggarwal
  1. Keep moving
    • Avoid holding one position for long.
    • While working get up and stretch every 15 minutes.
  2. Discover your strength
    • Put the strongest joints and muscles to work.
    • Push open heavy doors with the side of the arm or shoulder. It will protect finger and wrist joints.
    • While climbing up let the strong leg lead you and while going down let the weaker leg lead you. It will reduce hip or knee stress.
  3. Plan ahead
    • Simplify and organize your routines so you minimize movements that are difficult or painful.
    • Keep items you need for cooking, cleaning, or hobbies near where they are needed
    • Have multiple sets of cleaning supplies, one for the kitchen and one for the bathroom
  4. Make use of labor-saving devices and adaptive aids.
    • Long-handled grippers, can be designed to grasp and retrieve out-of-reach objects.
    • Rubber grips can help one get a better handle on faucets, pens, toothbrushes and silverware.
  5. Ask for help.
    • Only a very small percentage of people with arthritis become severely disabled and get dependent on others.
    • Educate family members and friends about how arthritis affects you.
    • Don’t be afraid to ask for help when you need it.
(Source Harvard Healthbeat)
ICON 2015 - the International Conference of IMA CGP on Family Practice inaugurated today at Country Inn Hotel, Delhi-NCR
New research suggests that being physically active not only reduces cognitive decline and improves neuropsychiatric symptoms in patients with dementia but may actually reduce biomarkers of Alzheimer's disease (AD), including amyloid and tau protein in the brain. The findings were presented at the Alzheimer's Association International Conference (AAIC) 2015.

Eliminating the bacterium Helicobacter pylori can reduce the risk for gastric cancer in healthy individuals, reported a systematic review of six trials published online July 22 in the Cochrane Database of Systematic Reviews.

Patients with bilateral adrenal incidentalomas appear more likely to have subclinical Cushing syndrome, as compared to those with unilateral incidentalomas, but surgery may not be the best approach to management, reported a study published online July 22 in JAMA Surgery.

Treatment with an immunosuppressant drug, alefacept,previously used for psoriasis, may have led to preservation of insulin-producing beta-cell function at 1 year after treatment cessation in patients with newly diagnosed type 1 diabetes, suggested a follow-up analysis from the Inducing Remission in New-Onset Type 1 Diabetes With Alefacept (T1DAL) study published July 21 in the Journal of Clinical Investigation.

Two types of drugs that are now available as inexpensive generic products, aromatase inhibitors and bisphosphonates, can reduce breast cancer mortality in postmenopausal women and could be used together to further improve outcomes, reported two meta-analyses published online July 24 in the Lancet.
Cardiology eMedinewS
  • The US Food and Drug Administration (FDA) has approved alirocumab for lowering LDL-cholesterol (LDL-C)for patients with heterozygous familial hypercholesterolemia or those at high CV risk who cannot lower their LDL-C with statins.
  • CPR given promptly by ordinary bystanders is linked to substantially higher survival among sudden cardiac arrest victims, suggests a new study published in the Journal of the American Medical Association.
Pediatrics eMedinewS
Infectious diseases

European Union (EU) regulators have approved the world's first malaria vaccine for use outside the EU among children aged 6 weeks to 17 months. The new vaccine, which includes a vaccine for hepatitis B, now awaits a review by the World Health Organization (WHO).

Allergy and Immunology

Inhaled corticosteroids cannot adequately protect children with asthma from high levels of air pollution and may actually exacerbate the effects of pollutants, reported a clinical study published online in the Journal of Clinical Allergy and Immunology.
Dr KK Spiritual Blog
Namkaran Sanskar

In India, a person is identified by his/her name, which usually is a reflection of his/her own family. It may contain not only your maiden name but also the name of your father and your surname/caste.

When you are born, you are usually given your special name, which you carry throughout your life unless it is changed for a specific purpose. For example, the surname may change after marriage or the in-laws may change the name, specifically, for a girl.

Artists often change their names to those which may reflect their profession. A classic example is Rajesh Khanna, who changed his name from Jatin to Rajesh, which was easier for the public to recall.

A name for a baby is chosen on any of the following grounds:
  • The priest as per the horoscope decides the sound present in the universe and that Akshar (Alphabet) is given to the family to pick up a name starting with that Akshar.
  • Sometimes, the name of the baby may be chosen depending upon the auspiciousness of the day he/she was born, e.g. a baby boy born on Krishna Janmashtami, may be named ‘Krishna’ by the family after Lord Krishna.
  • If the parents have vowed a Mannat to a deity, then they may name their child after one of the many names of that deity. For example, if parents have taken a Mannat from Vaishno Devi, their baby girl may be named for one of the forms of Goddess Durga or Parvati.
  • People may also choose similar names for their children, e.g. Ramesh, Mahesh, and Suresh.
  • People may also keep the name of the child in the form of known pairs. If the name of the first child is Luv, the parents may like to name the second child as Kush, especially when the parents have twins. Other examples are Karan Arjun, Sita and Gita etc.
  • Sometimes, parents name their child after their favorite celebrity. For example, if someone is a big fan of Sachin Tendulkar, he may name his child Sachin. Sachin himself was named after the noted Hindi film music director Sachin Dev Burman by his father, who was a great fan of SD Burman.
Name has a lot of significance as Akshar in Sanskrit has a vibration and if that positive vibration matches with the vibrations of universe at the time of your birth, it helps in healing.

Normally, it is expected that you live up to your name. For example, if your name is Durga, you are expected to know all about Ma Durga and try to adopt characteristics of Durga.

Therefore, everyone is expected to know the literal meaning of his or her name and try to follow a lifestyle that is consistent with your name. For example, if you are named Ram, you are not expected to act like Ravana.

Namkaran Sanskar or the naming ceremony is a complete ceremony and is one of the 16 sanskars. It is both a social and legal necessity. As the naming process creates a bond between the child and the rest of the community, it is considered auspicious.

Some people name their child before he/she is born but a Namkaran Sanskar is usually performed on the 12th day after birth but it may vary from religion to religion and custom to custom. The formal ritual involves a Namkaran puja, which is held at their home or a temple where the priest offers prayers to all the Gods, Navagrihas, five elements, Agni and the ancestors. The horoscope of a child is made and is placed in front of the idol of the deity for blessings. With the baby in the lap of the father, the chosen name of the child is whispered in the right ear.

Some people name the child on the 101st day of the birth; while some choose the first birthday to name their child.

The name of the child also entails certain etiquettes as it reflects a person. You cannot take the name of a person with disrespect. If you abuse a name it means you have abused a person.
Make Sure
Situation: A patient after sublingual nitrate developed fainting attack.
Reaction: Oh my God! Why was the systolic murmur missed on auscultation?
Lesson: Make sure that patient with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.
Dr Good Dr Bad
Situation: An elderly patient after IV ondansetron 16 mg dose developed irregular heart rhythm
Dr Bad: It cannot be due to the drug
Dr Good: It is due to the drug
Lesson: ECG interval changes, including prolongation of the QTc interval, are a class effect of the first-generation serotonin antagonists, including ondansetron; potentially fatal cardiac arrhythmias may result. QTc prolongation occurs in a dose-dependent manner, and is expected to be greater with faster rate of infusion and larger doses for IV administration. The current recommendation is to limit single IV doses to no more than 16 mg. Canadian guidelines place additional dosing restrictions on IV ondansetron to mitigate the risk of QT prolongation, particularly in older adults, in whom the initial dose should not exceed 8 mg (Source: healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2014/39943a-eng.php (Accessed on June 16, 2014).

(Copyright IJCP)
eMedi Quiz
A 40-year-old male had undergone splenectomy 20 years ago. Peripheral blood smear examination would show the presence of:

1. Dohle bodies
2. Hypersegmented neutrophils.
3. Spherocytes.
4. Howell-Jolly bodies.

Yesterday’s Mind Teaser: A 7-year-old girl from Bihar presented with three episodes of massive hematemesis and melena. There is no history of jaundice. On examination, she had a large spleen, non-palpable liver and mild ascites. Portal vein was not visualized on ultrasonography. Liver function tests were normal and endoscopy revealed esophageal varices. The most likely diagnosis is:

1. Kala azar with portal hypertension.
2. Portal hypertension of unknown etiology.
3. Chronic liver disease with portal hypertension.
4. Portal hypertension due to extrahepatic obstruction.

Answer for yesterday’s Mind Teaser: 4. Portal hypertension due to extrahepatic obstruction.
Correct Answers received from: Dr Poonam Chablani, Dr Bitaan Sen & Dr Jayashree Sen, Dr K V Sarma, Daivadheenam Jella, Dr Avtar Krishan.
Answer for 23rd July Mind Teaser: Clostridium perfringens infection
Correct Answers received: Asha Yahoo, Dr Poonam Chablani, Daivadheenam Jella, Dr Avtar Krishan.
eMedinewS Humor
A guy is walking up to a doctor’s office when a nun comes running out screaming and crying.

The guy walks in and says, "Doc, what’s with the nun?"

The doctor says, "Oh, I just told her she’s pregnant."

The guy says, "The nun’s pregnant?"

The doctor says, "No. But it certainly cured her hiccups!"
Rabies News (Dr A K Gupta)
What should be done with a patient who has had exposure but goes for treatment after considerable delay (weeks to months)?

An early and correct administration of modern anti-rabies vaccine is life-saving. The vaccination must be started immediately irrespective of the status of the biting animal. Patients who seek treatment after a delay of 48 hours or even months after having been bitten should be dealt in the same manner as if the exposure occurred recently.
IJCP Book of Medical Records
IJCP’s ejournals
CPR 10
Total CPR since 1st November 2012 – 110490 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
News on Maps
eIMA News
ICON-2015: Scientific Programme
ICON 2015
IMACGP International Conference of Family Medicine
Organized by: Indian Medical Association Headquarters, New Delhi
Hotel Country Inn, Sahibabad, UP on 25th & 26th July, 2015.

Sunday, July 26, 2015
9.00 AM – 11.00 AM

Session VIII: Guest Lectures (Each 30 minutes)


• Dr V C V Pillai, Trivandrum

• Dr Ashok Adhao, Nagpur

• Dr Anil Goyal, Delhi


Management – To prevent killer Diseases (30 Mins.)

Speaker: Dr Anand Pandey , New Delhi

ICON 2015 Dr R JAYCHANDRA REDDY ORATION: Newer Insulins (30 Mins.)

Speaker: Dr Y P Munjal, Delhi

ICON 2015 Dr G SAMARAM ORATION: Doctor Patient Communications (30 Mins.)

Speaker: Prof (Dr) A Marthanda Pillai, Padma Shri Awardee, National President, IMA

ICON-2015 Dr SUDIPTO ROY ORATION: Initiation and Intensification of Early Insulin Therapy (20 mins.)

Speaker: Dr Selvaraj , Tamilnadu

Session IX: IMA CGP Conference of Young Doctors Wing (Each 20 minutes)


• Dr K M Abul Hasan, Tamilnadu

• Dr J A Jayalal, Tamilnadu

ICON 2015 Dr JAGDISH C SOBTI ORATION: Family Medicine, Career by Choice (20 mins.)

Speaker: Prof (Dr) S Arul Rhaj, Chief Patron, IMA CGP

ICON 2015 Dr S N MISRA ORATION: “Bechara Main” (20 mins.)

Speaker: Dr K K Aggarwal, Padma Shri Awardee, Honorary Secretary General, IMA

ICON 2015 Dr DHARAM PRAKASH ORATION: Recent Developments in Medical Education (20 mins.)

Speaker: Dr Narendra Saini, Delhi

ICON 2015 Dr NARENDRA SAINI ORATION: A Landmark Service for Young Doctors by IMA - (IMA CGP SAATHI( (20 mins.)

Speaker: Dr K M Abul Hasan, Tamil Nadu
10.00AM – 11.00AM
Tea will be available
11.00 AM – 12.00 NOON

Session X: Webinar on Diabetes Mellitus


• Dr A Marthanda Pillai, Padma Shri Awardee, National President, IMA

• Dr K K Aggarwal, Padma Shri Awardee, Honorary Secretary General, IMA

Speaker: Dr Banshi Saboo, Ahmedabad
12.00 noon – 1.30 PM

12.00 noon – 12.40 PM

12.40 PM – 1.00 PM

1.00 PM – 1.30 PM

Session XI: Honour Lectures


• Dr Bakulesh Mehta, Mumbai

• Dr V C Shanmuganandan, Bangalore

• Dr Harish Gupta, Delhi

ICON 2015 Dr S S AGARWAL ORATION: Liver Transplantation: What every Doctor should know

Speaker: Dr Abhideep Chaudhary, Liver Transplantation Surgeon, Sir Ganga Ram Hospital, Delhi

ICON 2015 Dr N S CHANDRABOSE ORATION: Neonatal care for Family Physicians

Speaker: Dr M B Mathur, Neonatologist, LNJP Hospital , New Delhi

Panel Discussion: Doctor-Pharma Relations

Faculty: Dr Ajay Kumar, Member, MCI

Dr K K Aggarwal, Padma Shri Awardee, Honorary Secretary General, IMA

Dr Ravi Wankhedkar, Dhule

Session XII: FAMILY PRACTICE UPDATES (20 mins. each)


• Dr Jitendra B Patel, Ahmedabad

• Dr Sudipto Roy, Kolkata

ICON 2015 Dr V PARAMESHVARA ORATION: How to increase your income ethically

Speaker: Dr K K Aggarwal, Padma Shri Awardee, Honorary Secretary General, IMA

ICON 2015 Dr JAYSEELAN MATHIAS ORATION: Surgery in Hepatocellular Carcinoma

Speaker: Dr Raghavendra Rao, Saivani Hospital, Hyderabad

ICON 2015 Dr D R RAI ORATION: Maternal Mortality

Speaker: Dr Sangeeta Gupta, Delhi

ICON 2015 Dr J J SOOD ORATION: Newer advances in Bronchoscopy / EBUS

Speaker: Dr I M Chugh, Delhi
1.00 PM – 2.00 PM
2.00 PM – 3.00 PM

2.00 PM – 2.20 PM

2.20 PM – 2.40 PM

2.40 PM – 3.00 PM

Session XIII: Doctors Patient Relations (20 mins. each):


• Dr D R Rai , Delhi

• Dr Narendra Saini, Delhi

ICON 2015 Dr E PRABHAVATHI Distinguished Lecture: Health Insurance for Family Physician

Speaker: Dr Atul Arora, Delhi

ICON 2015 Dr ANIL PACHNEKAR Distinguished Lecture: Medico Legal issues in GP

Speaker: Dr T N Ravisankar, Chennai

ICON 2015 Dr V K MONGA Distinguished Lecture: Family Medicine & Patient safety

Speaker: Dr Akhil Sangal , Delhi

Session XIV: TB Update


• Dr R P Vashist, RTNCP, India

PANEL DISCUSSION: MDR TB – Today’s Challenge


• Dr Roopak Singla, LRS, Delhi

• Prof (Dr) Virender Singh, LHMC

• Dr K. S. Sachdeva, CTD

• Dr Ashwani Khanna, STO, Delhi

• Dr A. Srinivas, WHO
3.00 PM – 4.00 PM

3.00 PM – 3.20 PM

3.20 PM – 3.40 PM

3.40 PM – 4.00 PM
HALL-A: Session XV: Clinical Approach in Family Practice ( Each 20 minutes)


• Dr Jayesh Lele, Mumbai

• Dr Vinay Ranjan, Trivandram

• Dr. Rajeev Ardey, Delhi

ICON 2015 Dr P PULLA RAO Distinguished Lecture: Advances in Neurosurgery

Speaker: Dr V K Jain – Neurosurgeon, Delhi

ICON 2015 Dr D D Choudhury Distinguished Lecture: Ageing Spine, Newer Perspectives

Speaker: Dr H N Bajaj, Spine Orthopaedician, Delhi

ICON 2015 Distinguished Lecture: Lung Cancer US Pulmonary Tuberculosis

Speaker: Dr Durgatosh Pandey, Max Hospitals, Delhi
4:00 PM
HALL-A : ICON 2015 Distinguished Lecture: Dengue and its prevention


• Dr V K Monga, Delhi

Speaker: Dr K K Aggarwal, Padma Shri Awardee, Honorary Secretary General, IMA

Dr N K Yadav, Delhi
4:30 PM
  • The FDA granted approval to alirocumab (Praluent) for heterozygous familial hypercholesterolemia (FH) and for patients with clinical atherosclerotic cardiovascular disease, making it the first in the new class of lipid-lowering PCSK9 inhibitors. The FDA approval for alirocumab is widely expected to be followed closely by approval of evolocumab (Repatha) by Aug. 27.
  • In HIV patients coinfected with hepatitis C virus genotype 1 or 4, rates of sustained virologic response — defined as the absence of hepatitis C RNA — at 12 weeks reached 96% with a fixed-dose combination of ledipasvir and sofosbuvir (Harvoni, Gilead Sciences), results from the ION-4 study show. (Medscape)
  • Eliminating the bacterium Helicobacter pylori can reduce the risk for gastric cancer in healthy individuals, according to a systematic review of six trials published online July 22 in the Cochrane Database of Systematic Reviews. Medscape
  • Inhaled cannabis can blunt the pain of diabetic neuropathy without seriously impairing cognitive function (July issue of the Journal of Pain).
  • By targeting inflammation, adult allogeneic bone-marrow–derived mesenchymal precursor cells may represent a novel treatment for type 2 diabetes (July 7 in Diabetes Care)
  • Proprotein convertase subtilisin kexin 9 (PCSK9) is a serine protease produced predominantly in the liver that leads to the degradation of hepatocyte LDL receptors and increased LDL-C levels. Therapies that lower circulating PCSK9 levels significantly lower LDL-C levels. Monoclonal antibodies that inhibit PCSK9 (anti-PCSK9 abs) reduce LDL-C in a dose-dependent manner, by as much as 70 percent, and by as much as 60 percent in patients on statin therapy.Anti-PCSK9 abs reduced all-cause mortality, cardiovascular mortality, and MI.In particular, anti-PCSK9 abs appear to result in additional reductions in risk even in patients already on intensive or maximal statin therapy:
Inspirational Story
You are the Temple of God and the Spirit of God dwells in you

This sutra from the Bible reflects the union between the spirit and the soul. The ‘Spirit’ represents the Parmatama or the Brahman and ‘You’ represents the individualized spirit or the Soul (Jivatama).

A temple is a place of worship and also the place where God resides. Every human being represents a temple (place of worship) where God exists (one’s soul) and this soul is nothing but the essence of God (the spirit).

All individuals should be treated in the same manner as the same spirit dwells in every human being. The soul is also the reflection of individual’s past and present karmic expressions. Most people look for and search for God in artificial temples, gurudwaras and churches, not realizing that the same God is present within us, provided we undertake the internal journey to look for Him.

He is present in our thoughts in the silent zone and can be approached by adopting any of the three pathways: Karma Yoga, Bhakti Yoga and Gyana (Gnana) Yoga.

Doing selfless work with detachment to its results, working with the principles of duty, devotion and discipline and/or regularly doing Primordial Sound Meditation or other types of meditations can help one reach the stage of self-realization or meeting one’s true self. Once there, one can have all the happiness in life.
Quote of the Day
A total commitment is paramount to reaching the ultimate in performance. Tom Flores
IMA in Social Media
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Twitter @IndianMedAssn 1071 followers

http://imahq.blogspot.com/ www.ima-ams.org




Reader Response
Great results in a short period. New initiatives go a long way in taking the message all over Congrats NP AMP & HSG KKA. LVK Moorthy
Wellness Blog
What type of a vegetarian are you?

There are 4 main types of vegetarian diets:
  • Lacto–ovo–vegetarian consumes dairy products and eggs but no meat, poultry, or seafood
  • Lacto–vegetarian eats dairy products but not eggs, meat, poultry, or seafood
  • Ovo–vegetarian eats eggs but no dairy products, meat, poultry, or seafood
  • Vegan does not eat any animal products, including meat, fish, poultry, eggs, and dairy products; many vegans will also avoid honey.
Vegetarian and plant–based diets are associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fats and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease.
IMA Videos
Press Release
Over 500 family physicians across the country deliberate in ICON 2015

Inaugurating ICON 2015, Padma Shri Awardee, Dr A Marthanda Pillai, National President, Indian Medical Association (IMA) said, “Family Physicians are the backbone of the society. The recent proposal of the Government to increase the number of medical postgraduate seats and making them equal to MBBS seats will only harm the society in the long run. We need more family physicians, not specialists. If the Govt. wants to increase the number of postgraduate seats, they should do so in the field of Family Medicine.”

Addressing the gathering Padma Shri Awardee, Dr K K Aggarwal, Honorary Secretary General, IMA said, “IMA is in process of coming out with guidelines regarding a family practitioner relationship with a family.” General practitioners should adopt families and provide them comprehensive care, he further added.

Delivering the Dr Ketan Desai Oration, Dr S Arulrhaj, Chief Patron, IMA College of General Practitioners (IMACGP) said that a specialist consultation is not required for more than 90% of the illnesses. A family physician is able to take care of the same.

In a joint statement Dr E Prabhavathy, Dean, IMACGP and Dr V K Monga, Dean-Elect, IMACGP said that small medical establishments owned by IMA members should provide cost-effective treatment and care to the society.

Dr Sharad Agarwal, President, UP State Branch, Dr A Raja Rajeshwar, Honorary Secretary, IMACGP and Dr BB Wadhwa, Organizing Secretary, ICON 2015 said that the duty of a family physician is not only to treat patients, but also to refer them in time to an appropriate center, if required. A Family physician should also be able to guide his/her patients about hospitals where free and subsidized treatments are available, if they cannot afford the treatment.

Dr Preethi Wijegoonewardene from Sri Lanka and Dr Raman Kumar, President, Academy of Family Physicians of India (AFPI) also delivered orations.

Dr Viveka Kumar, Cardiologist who delivered the Dr NK Grover Oration and Dr Rajneesh Malhotra, who delivered the Dr BC Chhaparwal Oration, in a joint statement said that the public must know that India is second to none as far as tertiary cardiac care is concerned. Today, most private cardiac hospitals in India are saving millions of dollars as state of art cardiology services are available in the country at one-fifth of the cost.

In her talk, Dr E Prabhavathy, Dean, IMACGP highlighted the importance of diet control and exercise for young girls with polycystic ovarian syndrome before subjecting them to drug treatment.








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