August 2  2015, Sunday
Seven Common Causes of Forgetfulness
Dr KK Aggarwal
  1. Lack of sleep is the most common cause. Too little restful sleep can also lead to mood changes and anxiety, which in turn can contribute to memory impairment.
  2. Many drugs can affect memory, which includes tranquilizers, antidepressants, blood pressure drugs and anti–allergic drugs.
  3. Low functioning thyroid can affect memory.
  4. Drinking too much alcohol can interfere with short–term memory.
  5. Stress and anxiety can lead to memory impairment. Both can interfere with attention and block the formation of new memory or retrieval of old memories.
  6. Forgetfulness can be a sign of depression or a consequence of it.
  7. If you are vegetarian, vitamin B12 deficiency can loss memory impairment.
Prof. Anupam Sibal, Secretary General, Global Association of Physicians of Indian Origin (GAPIO), Group Medical Director, Apollo Hospitals Group, was conferred the BAPIO Award for promoting excellence in Patient Safety and Quality. The award was presented by Dr Virander Paul Deputy High Commissioner of India on 27th June 2015 at the BAPIO conference in Leicester UK.
Cardiology eMedinewS
  • Novel "antisense" drugs may be effective in targeting different apolipoproteins in patients with dyslipidemia, suggest the results from two early studies. Both the studies revealed that the apolipoprotein C-III (apoC-3) inhibitor known as ISIS 304801 reduced plasma apoC-3 and triglyceride levels. The first study was published in the July 30 issue of the New England Journal of Medicine, while the second one appeared in the Lancet.
  • Among heart-failure patients with low left ventricular ejection fraction (LVEF) who received an implantable cardioverter defibrillator (ICD), the EF improved in 40% of patients during follow-up, and was associated with lower all-cause mortality and fewer appropriate shocks, reported a new study published in the August 4 issue of the Journal of the American College of Cardiology. However, even among patients whose LVEF improved to >35% during follow-up, a few patients still had appropriate shocks in this cohort.
Pediatrics eMedinewS
Obstetrics and Gynecology

Babies conceived by women who drink alcohol around the time of conception face dramatically increased risks of type 2 diabetes and obesity in early middle age, suggested a University of Queensland study.


According to a meta-analysis of 11 studies in the August 2015 issue of Clinical Gastroenterology and Hepatology published online, neither childhood immunizations nor H1N1 influenza vaccination increased the risk of inflammatory bowel disease.
Dr KK Spiritual Blog
What is the importance of silence?

The true silence is the silence between the thoughts and represents the true self, consciousness or the soul. It is a web of energized information ready to take all provided there is a right intent. Meditation is the process of achieving silence.

Observing silence is another way of deriving benefits of meditation. Many yogis in the past have recommended and observed silence now and then. Mahatma Gandhi used to spend one day of each week in silence. He believed that abstaining from speaking brought him inner peace and happiness. On all such days he communicated with others only by writing on paper.

Hindu principles also talk about a correlation between mauna (silence) and shanti (harmony). Mauna Ekadashi is a ritual followed traditionally in our country. On this day the person is not supposed to speak at all and observes complete silence all through the day and night. It gives immense peace to the mind and strength to the body. In Jainism, this ritual has a lot of importance. Nimith was a great saint in Jainism who long ago asked all Jains to observe this vrata. Some people recommend that on every ekadashi one should observe silence for few hours, if not the whole day.

In his book, The Seven Spiritual Laws of Success, Deepak Chopra talks in great detail about the importance of observing silence in day to day life. He recommends that everyone should observe silence for 20 minutes every day. Silence helps to redirect our imagination towards self. Even Swami Sivananda in his teachings recommends observation of mauna daily for 2 hours. For ekadashi, take milk and fruits every day, study one chapter of Bhagwad Gita daily, do regular charity and donate one-tenth of your income in the welfare of the society.

Ekadashi is the 11th day of Hindu lunar fortnight. It is the day of celebration, occurring twice a month, meant for meditation and increasing soul consciousness. Vinoba Bhave was a great sage of our country known for his Bhoodaan movement. He was a great advocator and practical preacher of mauna vrata.

Mauna means silence and vrata means vow; hence, mauna vrata means a vow of silence. Mauna was practiced by saints to end enmity and recoup their enmity. Prolonged silence as the form of silence is observed by the rishi munis involved for prolonged periods of silence. Silence is a source of all that exists. Silence is where consciousness dwells. There is no religious tradition which does not talk about silence. It breaks the outward communication and forces a dialogue towards inner communication. This is one reason why all prayers, meditation and worship or any other practice whether we attune our mind to the spiritual consciousness within are done in silence. After the death of a person it is a practice to observe silence for two minutes. The immediate benefit is that it saves a tremendous amount of energy.

Silence is cessation of both sensory and mental activity. It is like having a still mind and listening to the inner mind. Behind this screen of our internal dialogue is the silence of spirit. Meditation is the combination of observing silence and the art of observation.
Make Sure
Situation: A patient with pyogenic meningitis developed complications.
Reaction: Oh my God! Why were antibiotics not given when the meningitis was suspected?
Lesson: Make sure that first dose of antibiotics is given at the time meningitis is suspected.
Dr Good Dr Bad
Situation: A diabetic patient was found unconscious.
Dr Bad: He has suffered a stroke.
Dr Good: First rule out hypoglycemia.
Lesson: In diabetics, sudden loss of consciousness is hypoglycemia unless proved otherwise.

(Copyright IJCP)
eMedi Quiz
The following separation technique depends on the molecular size of the protein:

1. Chromatography on a carboxymethyl (CM) cellulose column.
2. Iso-electric focusing.
3. Gelfiltration chromatography.
4. Chromatography on a diethylaminoethyl (DEAE) cellulose column.

Yesterday’s Mind Teaser: Presence of food might be expected to interfere with drug absorption by slowing gastric emptying, or by altering the degree of ionisation of the drug in the stomach. Which of the following statements is not a correct example:

1. Absorption of digoxin is delayed by the presence of food.
2. Concurrent food intake may severely reduce the rate of absorption of phenytoin.
3. Presence of food enhances the absorption of hydrochlorothiazide.
4. Anitimalarial drug halofantrine is more extensively absorbed if taken with food.

Answer for yesterday’s Mind Teaser: 3. Presence of food enhances the absorption of hydrochlorothiazide.
Correct Answers received from: Umesh Bansal, Dr Avtar Krishan, Dr K Raju.
Answer for 29th July Mind Teaser: 2. Hypovolemia.
Correct Answers received: Dr Kapil Roy, Dr Pravin H Patel.
Rabies News (Dr A K Gupta)
How is RIG life saving?

Administration of anti–rabies vaccine stimulates production of neutralizing antibodies by the patient’s immune system. Protective levels of antibodies (more than 0.5 IU/ml of serum) are seen 7 to 14 days after the initial dose of vaccine (window period). Moreover when the bites are on the head, neck, face and hands, the incubation period will be shorter. Thus the patients are vulnerable to develop rabies during this window period of 7 to 14 days. RIGs are readymade anti–rabies antibodies and provide passive immunity to rabies.
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
eIMA News

The US Food and Drug Administration (FDA) has approved topical azelaic acid 15% foam for treatment of the inflammatory papules and pustules of mild to moderate rosacea. The approval comes after the success of two pivotal vehicle-controlled 12-week clinical trials examining the efficacy and safety of twice-daily application of azelaic acid in patient with papulopustular rosacea



Insulin resistance is associated with lower brain glucose metabolism and poorer memory in late-middle-aged adults at risk for Alzheimer's disease, suggests a new study published online July 27 in JAMA Neurology.


Researchers looking into the health of women aged 40-70 have suggested that the amount of exercise they participate in during their teenage years appears to have an impact on their risk of dying from cancer or other causes as adults. The findings are published in Cancer Epidemiology, Biomarkers & Prevention.

Infectious diseases

Persistent severe back pain may indicate vertebral osteomyelitis, a rare spine infection that must be diagnosed and treated correctly to prevent serious complications, suggests a new Infectious Diseases Society of America (IDSA) guideline. The guideline was published online July 30 in Clinical Infectious Diseases.



Dermatologic complications affect about one in five patients with inflammatory bowel disease (IBD) on anti-tumor necrosis factor (anti-TNF) therapy, leading to discontinuation of treatment, suggests a French study published in the American Journal of Gastroenterology.
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Inspirational Story
Do not be jealous

We all have experienced how jealousy can disturb our peace of mind. You know that you work harder than your colleagues in the office, but sometimes they get promotions; you do not. You started a business several years ago, but you are not as successful as your neighbor whose business is only one year old. There are several examples like these in everyday life.

Should you be jealous? No. Remember everybody’s life is shaped by his/her destiny, which has now become his/her reality. If you are destined to be rich, nothing in the world can stop you.

If you are not so destined, no one can help you either. Nothing will be gained by blaming others for your misfortune.

Jealousy will not get you anywhere; it will only take away your peace of mind.
Quote of the Day
Dream is not that which you see while sleeping it is something that does not let you sleep. Dr APJ Abdul Kalam
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Reader Response
Another useful activity of DIGITAL IMA. All branches should adopt it State medical councils & MCI should grant credits to it. Dr Ravi Wankhedkar Consulting Surgeon & Coloproctologist
Over 70 doctors attended the IMA Rise & Shine CME on Vitamin D deficiency in Chennai
Wellness Blog
Heart disease begins in youth

Autopsy studies of young people who died in accidents have shown that by the late teens, heart blockages, the kind of lesions that cause heart attacks and strokes are in the process of developing.

The best opportunity to prevent heart disease is to focus on children and adolescents and start the preventive process early. More than a third of children and adolescents are overweight or obese.

The first signs that men are at higher risk of heart disease than women appear during the adolescent years despite the fact that boys lose fat and gain muscle in adolescence, while girls add body fat.

Between the ages of 11 and 19, levels of triglycerides, a type of blood fat associated with cardiovascular disease, increases in the boys and drops in the girls. Levels of HDL cholesterol, the "good" kind that helps keep arteries clear, go down in boys but rise in girls. Blood pressure increases in both, but significantly more in boys. Insulin resistance, a marker of cardiovascular risk, which is lower in boys at age 11, rises until the age of 19 years.

Any protection that the young women have for cardiovascular protection can be wiped out by obesity and hence obesity in girls should be handled on priority.
IMA Humor
Medical terms
  • Artery – Study of painting
  • Bacteria – Back door of cafeteria
  • Bowel – Letter like A.E.I.O.U.
  • Caesarean section – District in Rome
  • Cat scan – Searching for kitty
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Press Release
Depression, severe mental illness and loneliness not heart friendly

Depression, severe mental illness and loneliness are linked to heart disease and dementia, said Padma Shri, Dr. B C Roy & DST National Science Communication Awardee, Dr K K Aggarwal, President Heart Care Foundation of India and Honorary Secretary General Indian Medical Association (IMA).

A 3-year study by Dr Jesse Stewart, formerly of the University of Pittsburgh School of Medicine found a correlation between depression and hardening of the arteries. The arteries of those who are most depressed were narrowed twice as much as those who were least depressed, in the study. Hardening of the arteries is a precursor to a heart attack or stroke.

Depression may also upset the body’s regulation of glands that release chemicals governing energy level and growth, and alter the functioning of cells responsible for blood clotting.

Hardening of the arteries leads to an overreaction of the immune system and the resulting inflammation is known to release chemicals that can cause the disease.

Quoting a British study, Dr Aggarwal said that severely mentally ill people are more than three times as likely to die from coronary heart disease and stroke as those not suffering from mental illness. Mental illness more than doubled the risk of dying from heart disease for people up to the age 75. The risk of dying from heart disease was even higher among those taking antipsychotic medications.

A persistent feeling of loneliness among the elderly doubles the risk of developing Alzheimer's-like symptoms compared to those who felt connected to others.