February 3  2015, Tuesday
Seven Common Causes of Forgetfulness
Dr KK Aggarwal
  1. Lack of sleep is the most common cause. Two 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.
CPR 10-IITF-27th November 2013

News Around the Globe
  • The US Food and Drug Administration (FDA) has approved lisdexamfetamine dimesylate to treat binge eating disorder (BED) in adults. The drug is the first FDA-approved medication to treat this condition.
  • Results from a study published online in the Journal of Clinical Oncology that compared adjuvant radiotherapy (RT) with observation in women with "good-risk" ductal carcinoma in situ (DCIS), both "support" the decision to omit RT and "confirm" that RT offers "significant benefit in further reducing in-breast recurrence."
  • Treatment with the antiresorptive denosumab proved safe and effective over two years in men with low bone mineral density (BMD), reported the ADAMO trial published online in the Journal of Clinical Endocrinology and Metabolism.
  • A novel radio-guided surgical tool might be able to improve outcomes in neurosurgery, suggests new research. The beta-minus–emitting tracer technique called Y-90 DOTATOC effectively delineates the margins of meningiomas and high-grade gliomas. The findings are published in the January 2015 issue of the Journal of Nuclear Medicine.
  • Femtosecond laser-assisted LASIK and photorefractive keratectomy (PRK) are both associated with mild but statistically significant forward protrusion of the posterior cornea. A new study reported that the forward protrusion fluctuated for a year in patients who received LASIK, but stabilized as early as 3 months after patients received PRK. The report is published online in Ophthalmology.

Dr KK Spiritual Blog
You are the Temple of God and the Spirit of the 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 the 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).

One should treat every individual 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 are in the habit of looking and searching 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 between 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.

Cardiology eMedinewS
  • Use of a high-sensitivity troponin (hs-Tn) assay and sex-specific diagnostic thresholds doubles the number of MI diagnoses in women presenting with ACS, suggests a prospective study that also suggested women are less likely to receive evidence-based treatment than men despite the same diagnosis. The report is published online in the BMJ.
  • Researchers have found a link between insomnia that affects daytime function and hypertension, a well-established cardiovascular risk factor. The research is published in Hypertension.

Pediatrics eMedinewS
  • Researchers studying preschool children with autism spectrum disorder found that symptom severity and adaptive functioning varied among the children at diagnosis and changed over time. The study was published in JAMA Psychiatry.
  • A new study finds that individuals who start playing football before the age of 12 may be more likely to have memory and thinking problems as adults. The study is published in the journal Neurology.
Make Sure
Situation: A patient developed fainting attack after sublingual nitrate.

Reaction: Oh my God! Why was the systolic murmur missed on auscultation?

Lesson: Make sure that patients with left ventricular outflow tract (LVOT) obstruction are not given sublingual nitrates.
Can council take cognizance of a complaint being filed nine years after the incidence?

No. In a case DMC/DC/F-14/562/2009 decided on 2nd September, 2009, the council rejected a complaint of Shri JSR alleging professional misconduct on the part of Dr. AKK of Hospital X on the ground that the complaint has been made after a period of almost nine years and the same does not merit consideration and stands rejected.
Dr Good Dr Bad
Situation: A patient developed acute appendicitis within seven days of taking Mediclaim policy.

Dr. Bad: Mediclaim will cover.

Dr. Good: May not cover.

Lesson: Any diseases other than specified in clause 4.3 contracted by the insured person during the first 30 days from the commencement date of policy are not covered under Mediclaim.

(Copyright IJCP)
IJCP Book of Medical Records
IJCP’s ejournals
eMedinewS Humor
Good Treatment

Bob went over to his friend Joe’s house and was amazed at how well Joe treated his wife. He often told her how attractive she was, complimented her on her cooking and showered her with hugs and kisses. "Gee," Bob remarked later, "you really make a big fuss over your wife". "I started to appreciate her more about six months ago," Joe said. "It has revived our marriage and we couldn’t be happier."

Inspired, Bob hurried home, hugged his wife and told her how much he loved her and said he wanted to hear all about her day. But she burst into tears. "Honey," Bob said, "what’s’ the matter?" "This has been the worst day," she replied. "This morning Billy fell off his bike and broke his ankle, then the washing machine broke. Now to top it off, you come home drunk!"
Twitter of the Day
Dr KK Aggarwal: The very purpose of life is to face sufferings…According to Hinduism, the very fact http://bit.ly/15QdVeB #Health

Dr Deepak Chopra: Your true self is nameless & formless http://bit.ly/15QdVeB #Health
CPR 10
Total CPR since 1st November 2012 – 101090 trained
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,
Rabies News (Dr A K Gupta)
Is sera testing of IDRV patients for antirabies antibodies necessary as a measure of knowing its efficacy?

Routine sera testing for rabies antibodies to know its efficacy is not required.
Video of the Day
About the Editor

Padma Shri, National Science Communication and Dr B C Roy National Awardee, Honorary Secretary General IMA, Immediate Past Senior National Vice President IMA, Professor of Bioethics SRM University, Sr. Consultant Medicine & Cardiology, Dean Board of Medical Education, Moolchand, President Heart Care Foundation of India, Chairman Legal Cell Indian Academy of Echocardiography, Editor in Chief IJCP Group of Publications & eMedinewS, Member Ethics Committee Medical Council of India (2013-14), Chairman Ethical Committee Delhi Medical Council (2009-14), Elected Member Delhi Medical Council (2004-2009), Chairman IMSA Delhi Chapter (March 10- March13), Director IMA AKN Sinha Institute (08-09), Finance Secretary IMA (07-08), Chairman IMAAMS (06-07), President Delhi Medical Association (05-06)
The current measles outbreak in the United States should serve as a wake-up call, a federal health official said.

NABH Update

NABH Accreditation Standards for Wellness Centres prepared by the technical committee contains complete set of standards for evaluation of Wellness Centres for grant of accreditation. The standards provide framework for quality of care for customers and quality improvement for Wellness Centres.

Tip of the day for safe and effective strength training

Always warm up and cool down properly.

10 Worst Medical Treatment Dangers 2015

Ventilator Disconnections

A complete or partial disconnection along the breathing circuit could quickly lead to anoxic brain injury and death. That's why ventilators incorporate sensors and alarms to warn when a disconnection occurs. Such alarms must be set to appropriate levels and must be heard when they sound. ECRI Institute has investigated cases in which serious patient harm resulted from alarms being set to inappropriate levels so that the alarm didn't activate or the staff didn't hear it.
(Source: Medscape)

Medscape Family Physician Lifestyle Report 2015

Do Family Physicians Burnout Rates Differ among Ages?

Burnout rates are lowest in the youngest and oldest family physicians, although even family physicians under 35 report burnout rates of 43%. Burnout peaks in mid-life, with well over half of family physicians reporting burnout (57% of those between 36 and 45 years of age and 58% of those 46-55) and then declines to 26% in family physicians 66 and over.

Launch of IMA Rise and Shine Web Lecture Series
Date of webcast
8th February 2015
Time of webcast
11:00 AM - 11.30 AM
Live webcast
Opening remarks and introduction of National President IMA
Dr K K Aggarwal, Honorary Secretary General, IMA - 2 minutes
Address by National President IMA
Dr Marthanda Pillai, National President – IMA - 7 minutes
Introduction of Dr. Anupam Sibal, Group Medical Director Apollo Hospitals
Dr K K Aggarwal, Honorary Secretary General, IMA - 1 minute
Introduction of Dr Prathap C Reddy Chairman Apollo Hospitals Group
Dr Anupam Sibal, Group Medical Director, Apollo Hospitals - 3 minutes
Leadership Qualities: My personal Journey and Healthcare challenges
Dr Prathap C Reddy, Chairman Apollo Hospitals Group - 15 minutes
Concluding Remarks and Thanks
Dr K K Aggarwal - 2 minutes
Inspirational Story
The Legacy of Health

Most of the time, in the pursuit to do what is best, we forget to fulfill the mandatory needs of our children. All they need is our unconditional love and support at every step in their lives, but, we spend the time by accumulating as much wealth as we can, at the cost of our own health.

All of our problems erupt from a bad life style, long working hours, unhealthy food habits and bottling up of unwanted stress. Surprisingly we are all well aware of these facts, but keep on ignoring them, till things go out of hand and make us just too weak to work. That's the time when we rush to doctors. Doctors cannot cure completely; they can only treat the problem.

Health is wealth, it needs all the attention all the time; it must be our topmost priority. The worst part is that wealth may or may not be hereditary, but health is. So, if we are not healthy, how do we pass on the wealth of our health to our children for them to enjoy? Yesterday life was difficult and living was easy but today life is easy and living is difficult.

We, as Indians, have a rich cultural lineage that enables us to lead a healthy and subsequently a wealthy life under all conditions, lest we believe in exporting our culture to western countries, to be approved by them, and only then we put it into use.

Let's preserve it for our future generations or else it will be destroyed. This can be only done if we inculcate them, in our own daily lives, and pass them on to our children by leading a self disciplined routine life, with a positive outlook, strong moral ethics and values.

Controlling and channeling the negative into positive, works wonders for our mind, body and soul. Like food, exercise of any kind, be it yoga aerobics or even simple walking is compulsory. Taking care of one's own self is not being selfish or self-centered. Pamper yourself by taking good care of your body. It's said a healthy body inhabits a healthy mind.

When one is in good health, only then can one take care of his loved ones and enjoy the pleasures of life in all ways possible. The legacy of health has no substitute for our future generations to come.
Quote of the Day
Anxiety does not empty tomorrow of its sorrows, but only empties today of its strength. Charles Spurgeon
IMA in the News
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Reader Response
Sir very nice information on health insurance and sexual abuse child.A great information on advising anti hypertensives in night. regards: DR D Harishkumar
Wellness Blog
What type of a vegetarian are you?

There are 4 main types of vegetarian diets
  1. Lacto–ovo–vegetarian consumes dairy products and eggs but no meat, poultry, or seafood
  2. Lacto–vegetarian eats dairy products but not eggs, meat, poultry, or seafood
  3. Ovo–vegetarian eats eggs but no dairy products, meat, poultry, or seafood
  4. 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 low in fat, particularly saturated fat, and high 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.
eMedi Quiz
Commonest cause of sporadic encephalitis is:
1. Japanese B virus
2. Herpes simplex virus.
3. Human Immunodeficiency virus.
4. Rubeola virus.
Yesterday’s Mind Teaser: A 70-year-old male patient presented with history of chest pain and was diagnosed to have coronary artery disease. During routine evaluation, an ultrasound of the abdomen showed presence of gallbladder stones. There was no past history of biliary colic or jaundice. What is the best treatment advice for such a patient for his gallbladder stones?
1. Open cholecystectomy.
2. Laparoscopic cholecystectomy.
3. No surgery for gallbladder stones.
4. ERCP and removal of gallbladder stones.
Answer for yesterday’s Mind Teaser: 3. No surgery for gallbladder stones.
Correct Answers received from: Daivadheenam Jella, Tukaram Pagad, Dr Avtar Krishan, Dr M Mahesh, Dr Jainendra Upadhyay.
Answer for 1st Feb Mind Teaser: 1. G0-G1-S-G2-M.
Correct Answers receives: Dr KV Sarma, Dr Avtar Krishan, Daivadheenam Jella.
IMA Videos
News on Maps
The Year in Medicine 2014: News That Made a Difference
New Diagnostic Tests, Biomarkers for Disease

A new "electronic nose" is capable of detecting prostate cancer from a urine sample with nearly 80% accuracy, according to a proof-of-concept pilot study. Noninvasive prenatal DNA testing in low-risk women may be as useful in a general obstetric population as it is in high-risk pregnancies, but there is still some debate about whether guidelines should change regarding its use.

A new blood test may identify major depressive disorder in adults, and could potentially help clinicians predict which patients with the disorder will respond to cognitive-behavioral therapy. Alterations in a gene linked to stress reactions may eventually help clinicians identify patients at increased risk for suicidal behavior, including attempts, potentially by way of a simple blood test, recent research shows. (Source: Medscape)
Press Release of the Day
IMA Flu Update on antiviral drug oseltamivir

Mild to moderate flu requires no antiviral drugs

People do not die of swine flu but of swine flu pneumonia and other complications. So, if there is no breathlessness, then there should be no panic, said Padma Shri Awardees Dr A Marthanda Pillai National President and Dr K K Aggarwal Honorary Secretary General IMA in a joint statement.

Flu means fever with muscle pains, cough and cold. In patients with mild to moderate disease and in whom the symptoms are not going to last long, antiviral drugs and tests are not needed.

"But at this time of year, if a person has fever of 103°F with massive muscle aches and a cough, it is swine flu unless proved otherwise. It is justifiable to start swine flu anti viral drug within 48 hours of onset of symptoms even without going for the test. But if one has low-grade fever and feels just a bit poorly, no drug or test may be prescribed," added Dr Aggarwal.

“Remember if you need to give, then give antiviral agents as early as possible. If you start the drug within 48 hours of onset of symptoms, you will see an improvement, in about 30 hours in time, to getting better, but if you start the drug after 48 hours, there is no discernible benefit," said Dr Aggarwal.

IMA guidelines said that “however in hospitalized patients, treating these patients more than 48 hours after onset of symptoms still provides some benefit.”

As per CDC and IMA guidelines, for someone who is sick enough to be in the hospital and perhaps in the ICU, using the 48-hour cut-off for treatment is not appropriate. However, it is still important to start treatment as early as possible, because 24 hours results are better than 48 hours and 48 hours results are better than 96 hours in terms of reduction in ICU admission or death.

Regarding antibiotics, IMA guidelines state that out of 99 influenza cases less than one will get bacterial super infection leading to pneumonia. It is true that flu predisposes to bacterial pneumonia but giving an antibiotic will not prevent it. And if you treat all 99 of them with antibiotics there will be more complications like rashes, diarrhea and drug resistance than benefits.