November 29   2015, Sunday
emedinexus emedinexus
Dr KK AggarwalDr KK Aggarwal Dear All

As you know, the annual national conference of Indian Medical Association is on 27th and 28th of December.

The registration so far has not been encouraging. Since the venue of the conference comes under the notified area, entry to the venue will be on the basis of bar-coded identity cards. Hence all the members are advised to register in advance to avoid inconveniences

The central council this time will be deliberating on major professional issues including strong protest against the government in case the ongoing negotiations are not to our satisfaction. So participation of all the central council members in earnestly solicited.

Make the NATCON a great success by your presence and participation

For registration details, please log on to

Important contact details are given below

Dr Vinay Aggarwal 9811050403
Dr Ajay Lekhi 9810057136
Dr Alok Bhandari 9811081892
Dr RN Tandon 9810089490

See you all at the NATCON


Prof Dr A Marthanda Pillai                                                                                                              Dr.K.K.Aggarwal
National President                                                                                                               Honorary Secretary General
Amit Sharma and Nilesh Aggarwal

We are extremely happy to have been part of IMA Satyagraha campaign and would like to congratulate the Indian doctor community as a whole. We are aiming to be a digital voice of all Indian doctors and will continue to work towards raising such important issues. Currently, we are in our Beta phase and we will soon be introducing features such as interesting cases, online CME's, conference updates etc. Please do register and read eMediNews, eIMANews as well as other engaging content on the website/app. You can also add other doctors to your network, find long lost alumni, chat and discuss cases, post questions for the medical fraternity, create your detailed medical resume and lots more.
Breaking News
Nationwide Registry for Organ and Tissue Donation launched

While noting that donating organs is a gift of life and is an altruistic, egalitarian and essentially moral act, Shri J P Nadda, Union Minister of Health and Family Welfare urged people to come forward and donate organs to save lives. He stated that this noble act can ameliorate the suffering of all those needy patients who need our support. He was speaking at a function on the occasion of 6th Indian Organ Donation Day organized by National Organ and Tissue Transplant Organization (NOTTO), Directorate General of Health Services, Ministry of Health and Family Welfare, here today. Shri C Vijaya Baskar, Health Minister of Tamil Nadu was also present. The Health Minister also launched the nationwide registry of National Organ and Tissue Transplant Organization at which meets the demand-supply gap between those who require transplantation and those who can meet this requirement. While earlier only kidney donors were included in this registry, now it caters to demand for kidney, liver and heart transplantation also… (PIB)

Adolescent deaths from AIDS tripled since 2000

The number of adolescent deaths from AIDS has tripled over the last 15 years with 26 new infections occurring every hour, the UN Children's Fund (UNICEF) announced and warned that “it is critical that young people who are HIV-positive have access to treatment, care and support.” “At the same time, those who are HIV-negative must have access to the knowledge and means to help them to stay that way,” said Craig McClure, head of UNICEF's global HIV/AIDS programmes, at a conference in Johannesburg, South Africa, where new data was released by UNICEF. AIDS is the top cause of death among adolescents (15-19) in Africa and the second leading cause of death among adolescents globally. In sub-Saharan Africa, the region with the highest prevalence, girls are vastly more affected, accounting for 7 in 10 new infections among 15-19 year olds. “Among HIV-affected populations, adolescents are the only group for which the mortality figures are not decreasing,” according to UNICEF…… (UN News Center)
Dr Good Dr Bad
Make Sure
IMA Digital TV
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Specialty Updates
• The probiotic Bifidobacterium breve does not help prevent late-onset sepsis or necrotizing enterocolitis in preterm infants, suggests new research published in The Lancet.

• The routine addition of aspiration thrombectomy before PCI does not improve clinical outcomes at 12 months in patients with non-ST-elevation myocardial infarction (NSTEMI), reported a randomized trial published in the European Heart Journal: Acute Cardiovascular Care.

• A follow-up study to assess the effects of personally tailored diabetes care in general practice has revealed that such care reduces mortality (both all-cause and diabetes-related), in women, but not men. The findings are published in Diabetologia.

• A new study, published in the Proceedings of the National Academy of Sciences, suggests that loneliness can alter the immune system cells in a way that increases susceptibility to illness.

• Patients with acute complicated appendicitis who received 5 days of postoperative antibiotic treatment after laparoscopic appendectomy surgery did not have a reduction in infectious complications in comparison to patients receiving only 3 days of postoperative antibiotic treatment, suggested a new study published online in JAMA Surgery.

• Bevacizumab may help improve surgical outcomes in locally advanced gastric cancer, suggests new research published online in Medicine. Researchers noted that adding bevacizumab to neoadjuvant docetaxel/oxaliplatin/5-fluorouracil/calcium folinate can improve the curative (R0) surgery resection rate and disease-free survival and these effects might be associated with lower circulating tumor cell counts.

• A new study suggests that women with moderate-to-severe premenstrual syndrome (PMS) had a 40% higher risk of developing high blood pressure over the following 20 years compared to women experiencing few menstrual symptoms. The findings are published in the American Journal of Epidemiology.

• A new study uncovers an important step in the malaria parasite's ability to gain a foothold in the human liver, where it replicates before spreading to the bloodstream, thus leading to new ways to block parasite infection. The findings are published in the journal Science.
Think differently in mythology

• Lord Ganesha with the elephant’s head depicts that one should use their wisdom before taking any decision.
• Vishnu’s first incarnation, fish, symbolizes learning to swim in the opposite direction.
• Brahma’s five heads mean to use all your five senses before taking any decision.
• Shiva’s third eye means to think differently in difficulties.
• Ravan’s ten heads mean using your ten senses/emotions before taking any decision. But, Ravan used them for negative forces.
• Maha Mrityunjaya mantra begins as we worship the three-eyed Shiva.
• Gayatri mantra means that one should ask the heart to direct the intellect to take the right decision. The 3H philosophy is linked to the same. The first H is ask the head for options; second H is to ask the heart to choose one of the options and the third H means to order the hand to do the action
Legal Quote

Samira Kohli vs Dr. Prabha Manchanda and Anr, SCI, Civil Appeal No. 1949 of 2004, 16.01.2008

”……… in Medical Law, where a surgeon is consulted by a patient, and consent of the patient is taken for diagnostic procedure/surgery, such consent cannot be considered as authorisation or permission to perform therapeutic surgery either conservative or radical (except in life threatening or emergent situations). ”
Digital IMA
IMA Digital TV
IMA Digital TV
Retirement Income Analysis

The Retirement Income Analysis estimates all the sources of income upon retirement. Income tax is then calculated on that amount. Once the after-tax retirement income is calculated, it is then compared to the after-tax retirement income goal. To make the report even more realistic, the desired after-tax retirement income should be inflated to reflect the desired income in inflated rupees that provide the same purchasing power as today’s rupees.

(Source: IJCP)
22nd MTNL Perfect Health Mela, the annual flagship event of the Heart Care Foundation of India
Dear Leaders

The technical committee on amendments to PCPNDT Act was held on 24th November 2015. For the first time, IMA was included in this committee. IMA was represented by the National President and Secretary General.

IMA could strongly put across the need for amendment of clause 23 and 25 which deal with criminal procedures for violation of any of the rules and bye-laws of the act. IMA demanded graded punishment and inclusion of a sub-clause in Clause 25 to deal with non-compliance other than sex determination and aiding and abetting female foeticide.

IMA hopes that similar ministerial meetings on other amendments demanded by us will take place culminating in the inter-ministerial committee meeting.

Best regards

Prof Dr A Marthanda Pillai                                                                                                              Dr K K Aggarwal
National President                                                                                                               Honorary Secretary General

Acute pharyngitis is one of the most common conditions encountered in office practice, accounting for 12 million ambulatory visits in the United States annually.
Western BP guidelines put Asians at stroke risk

Authors of a study published in the journal Heart Asia note that the recent Western blood pressure guidelines may actually increase the stroke risk if used for Asian patients, particularly the elderly. High blood pressure among Asian populations has unique features in terms of the response to drug treatment, risk of complications, and outcomes. This leads to much higher mortality and morbidity from stroke vs Western populations. Although evidence-based and qualified guidelines have been recently released from Europe and North America, the unique features of Asian hypertensive patients raise concerns on the real clinical applicability of these guidelines to Asian populations……… (Times of India)
Obesity no more the ailment of the rich

The results of a nationally representative survey imply that obesity has trickled down to all levels of society, fuelled, in part, by India's rapid economic growth in recent years. More than 7000 people from 6 Indian states (Rajasthan, Uttar Pradesh, West Bengal, Assam, Maharashtra and Karnataka) were surveyed in 2010 as part of the international Study on global AGEing and adult health (SAGE), and involved only those aged 50 and above. The survey included measurements of height, weight, waist circumference and blood pressure. The study is published in the online journal BMJ Open… … (Times of India)
Including evaluation of the menstrual cycle as a vital sign can alert healthcare providers to disorders that cause abnormal uterine bleeding in adulthood, according to a committee opinion from the American College of Obstetricians and Gynecologists, published online and in the December issue of Obstetrics & Gynecology. The opinion states, "Just as abnormal blood pressure, heart rate, or respiratory rate may be key to diagnosing potentially serious health conditions, identification of abnormal menstrual patterns in adolescence may improve early identification of potential health concerns for adulthood."
National Skill Development Centre to focus on vocational training for paramedics & medical technicians

The National Skill Development Centre will focus on vocational training for paramedical requirement particularly in segments including emergency ambulatory services, X-ray, Echo, tread mill test (TMT) along with a pool of technicians for blood banks, laboratories, anesthesia, cardiac and dialysis. This will bring about a paradigm change to have access to trained workforce. The quality of training for both paramedics and technicians to handle medical equipment at present is a cause for concern. The testing, certification and accreditation system is inadequate and there are no efforts to evaluate their outcomes……(Pharmabiz - Nandita Vijay)
High amyloid signals cognitive decline in normal population

Elevated amyloid levels were associated with worse cognition and greater cognitive decline and neurodegeneration in general population of persons with normal cognition at baseline. According to Ronald C. Petersen, MD, Mayo Clinic, Rochester, Minnesota, lead author of the study, individuals in the general population who are amyloid positive but cognitively normal are at an increased risk of progressing to cognitive impairment at the rate of about 8-10% per year, compared to a rate of 1-2% in the general population who are not amyloid positive. The findings of the study are published online in JAMA Neurology on November 23… …… (Medscape)
WP(C) No.8706/2015 titled “Indian Medical Association Vs. Union of India & Anr (NCERT)” Delhi High Court, New Delhi

Click here to read the proposed changes
IMA Live Webcast

Click here

Central India Unit of the UNESCO Chair in Bioethics,
Haifa and IMA UNESCO Chair in Bioethics,

December 11, 2015, 9:00A.M
PGIMER - RML Hospital, New Delhi

For Registration for 16 IMA Nominee
Phone: 9811841351
Dr. R.P Beniwal
Bioethical issues in medical practice
Perils of Cosmetic Surgery

Smita N Deshpande
Head, Dept. of Psychiatry, De-addiction Services
PGIMER-Dr. Ram Manohar Lohia Hospital
Park Street, New Delhi

Young people today are extremely health and appearance conscious. Not only do they follow strict dietary regimens, they religiously take care of their appearance. Repeated surgery for changing the shape of their nose, chin or stomach is frequent. You as a family physician are approached by one such young woman, who has a normal shape and weight but wants liposuction. What should your primary advice/counselling center on?

a) Healthy lifestyle choices
b) Being comfortable with their natural appearance, whatever it may be
c) Perils of cosmetic surgery
d) Involving their family

Any other suggestions and solutions? Do write in!

Adapted from: Bioethics Case Studies (AUSN and EEI, November 2013):

Response received

Perils of cosmetic surgery should be explained to her and when completely satisfied, liposuction should be got done. This will not only change her outlook and appearance but also will be helpful in controlling hypertension, diabetes, PCOD, sterility and various conditions related to cardiovascular system. Dr BR Bhatnagar
IMA Digital TV
Inspirational Story
The Alphabet of Happiness

A – ACCEPT: Accept others for who they are and for the choices they’ve made even if you have difficulty understanding their beliefs, motives, or actions.

B – BREAK AWAY: Break away from everything that stands in the way of what you hope to accomplish with your life.

C – CREATE: Create a family of friends whom you can share your hopes, dreams, sorrows, and happiness with.

D – DECIDE: Decide that you’ll be successful and happy come what may, and good things will find you. The roadblocks are only minor obstacles along the way.

E – EXPLORE: Explore and experiment. The world has much to offer, and you have much to give. And every time you try something new, you’ll learn more about yourself.

F – FORGIVE: Forgive and forget. Grudges only weigh you down and inspire unhappiness and grief. Soar above it, and remember that everyone makes mistakes.

G – GROW: Leave the childhood monsters behind. They can no longer hurt you or stand in your way.

H – HOPE: Hope for the best and never forget that anything is possible as long as you remain dedicated to the task.

I – IGNORE: Ignore the negative voice inside your head. Focus instead on your goals and remember your accomplishments. Your past success is only a small inkling of what the future holds.

J – JOURNEY: Journey to new worlds, new possibilities, by remaining open-minded. Try to learn something new every day, and you’ll grow.

K – KNOW: Know that no matter how bad things seem, they’ll always get better. The warmth of spring always follows the harshest winter.

L – LOVE: Let love fill your heart instead of hate. When hate is in your heart, there’s room for nothing else, but when love is in your heart, there’s room for endless happiness. (To be continued…)
eMedi Quiz
Following are true about gluten except:

a. Gluten-rich foods are wheat, rye, and barley.
b. Soybean or tapioca flours, rice, corn, buckwheat, and potatoes have no gluten.
c. Stabilizers or emulsifiers never contain gluten.
d. Distilled alcoholic beverages and vinegars, as well as wine, are gluten free.
e. Beers, ales, lagers, and malt vinegars are often made from gluten-containing grains.

Yesterday’s Mind Teaser: Which one of them is not true about celiac disease?

1. Celiac disease is a large bowel disorder
2. It is characterized by mucosal inflammation, villous atrophy, and crypt hyperplasia, which occur upon exposure to dietary gluten and which demonstrate improvement after withdrawal of gluten from the diet.
3. Several categories of celiac disease have emerged (asymptomatic, silent (i.e., asymptomatic and no evident malabsorption or other disease manifestations), potential (i.e., positive celiac-specific serology with normal histology)).
4. The natural history of these various forms of celiac disease is incompletely understood.
5. The log-term risk of complications in patients who are asymptomatic is unclear. Such patients may also be least likely to comply with a gluten-free diet.

Answer for Yesterday’s Mind Teaser:1. Celiac disease is a large bowel disorder

Answers received from: Dr.B.R.Bhatnagar, Dr Kailash Chandra Sharma, Dr Avtar Krishan

Answer for 27th November Mind Teaser : 4. Superior vena caval obstruction.

Answers received from: Dr Poonam Chablani, Dr Jainendra Upadhyay, Dr.K.V.Sarma, Dr.B.R.Bhatnagar, Dr Kailash Chandra Sharma, Dr Avtar Krishan
A teacher talking to a student

Teacher: Did your father help you with your homework?

Student: No, he did it all by himself.
Readers column
Dear KK, your emedinews is very informative. Regards: Dr Krishna
Press Release
IMA opposes the ART bill; feels it is not community friendly

Medical experts from around the world are vigorously working on enhancing human reproductive science by devising alternative ways to ease and diversify the existing options. As a result, it has become possible for childless couples and single parents to experience the joys of parenthood. ART comes as a ray of hope to the 15 million infertile couples residing in India. The concept has become extremely popular in the country over the past decade with childless couples flocking infertility clinics for options such as IVF and surrogacy.

In the wake of its growing popularity, there is no denying that a staunch and well-worked regulation is needed to supervise the functioning of thousands of IVF clinics. However the ART Bill scheduled to be tabled in the parliament lacks a humanistic approach. The Bill tries to address the prevailing problems by restricting the availability of ART options to a certain section of the population. In addition to this, it also puts stringent rules on IVF clinics, which in reality are not practical and will only cause an increase in the number of cases of violence and unwarranted legal suits against them.

Keeping this in mind the Indian Medical Association along with eight partner associations have together raised a strong opposition to the ART bill on six primary grounds. They have together initiated a petition, which has already been signed by over 7000 doctors.

Expressing the concern, Padma Shri Awardee Dr. A Marthanda Pillai –National President IMA and Padma Shri Awardee Dr. KK Aggarwal, Honorary Secretary General, IMA and President, HCFI said, “The proposed ART Bill has a number of loopholes, one of them being that it bars foreign couples from opting for surrogacy procedure in India. It also remains silent on laws for single parents and same sex couples. Restricting the services to a section of the society is not community friendly and we at Indian Medical Association feel that major revisions are needed before the act is implemented. The need of the hour is for a liberal and ethical ART law, which keeps a check on any exploitation by untrained and non-medical personnel while allowing trained IVF experts to function autonomously. The Act should be formulated in consultation with leading stakeholders like the IMA, ISAR, FOGSI, IFS, INSTAR, FPS (I), USI and other such organizations which are representative of the masses and experts in the field”.

The six amendments required in the current bill as demanded by the IMA and key stakeholders including Dr. Prakash Trivedi, President FOGSI; Dr. H D Pai, President ISAR; Dr. Himanshu Bavishi, President INSTAR; Dr. Sonia Malik, President IFS; Dr Nalini Mahajan, President FPS(I); Dr. Jaideep Malhotra from Smriti Trust; Dr. P. Chibber, President USI; Dr.Narendra Malhotra. President Elect ISAR; Dr Maninder Ahuja, Gynaecologist and Dr.Alka Kriplani President Elect FOGSI include:

1. The age criterion to avail ART services should be the legal age i.e., 18 years and above and marriage should not be made a compulsion to avail ART services.

2. Medical acts are done in good faith and thus, presuming a doctor to be guilty without any proof goes against the very basic spirit of the law of the land.

3. Handling of Semen outside the body should not be brought under the umbrella of the ART Bill as this a basic service at the primary level. Hence, the treatment of IUI should be removed from the existing bill.

4. The ART Bank provisions in the current act are vague and arbitrary. There is a need to relooked and review these.

5. The number of oocytes to be retrieved and embryos to be implanted should be the decision of the treating doctor and not of the State authorities.

6. Commercial surrogacy caters to only 2% of the patients. Ethical and regulated surrogacy should thus be allowed for both Indian Nationals as well foreign nationals including OCI/PIO cardholders.