Tuesday, May 31, 2011

Golden hours in medical practice

One should not ignore warning signals as “time is life” in medical science.  The three cardinal warning signals are: anything which is unusual, anything which cannot be explained and any symptom appearing for the first time in life. Time is life is an old saying. In heart attack time is muscle and in brain time is brain.

Most acute emergencies will require emergent evaluation and treatment. Delay in treatment even of minutes can take away the life. In emergency one should not waste time to think, rush to a bigger hospital with full facilities and make sure that the person is attended to in time. Many hospitals may have ill equipped emergency departments or may have inadequately trained staff. In nursing homes the ER doctor may be from other systems of medicine.


In emergency medicine, the golden hour refers to the first hour following traumatic injury being sustained by a casualty, during which there is the highest likelihood that prompt medical treatment will prevent death. If bleeding can be stopped and person can be infused enough fluids within first hour most trauma death can be avoided.

Platinum ten minutes refers to first ten minutes after trauma and refers to  the importance of starting first aid within ten minutes to reduce the chances of death.

Door to ECG Time is an important terminology in the treatment of heart attack. One should get an ECG within 10 minutes of chest pain. A prolonged door-to-ECG time is associated with an increased risk of clinical outcomes in patients with ST elevation heart attack.

Door-to-Doctor Time in Stroke is another term. In emergency department arrival to initial physician evaluation should be less than 10 minutes in stroke or the mortality will be high.
Door to neurologist time is for the specialist. In emergency department arrival to Paralysis Stroke Team Notification time should be less than 15 minutes.
Door to CT scan time is the time before which the CT should be done in suspected paralysis. In the emergency department arrival to CT Scan initiation in stroke should be less than   25 minutes. Door-to-CT Interpretation in stroke should be < 45 minutes
Door to tPA time is the treatment window in paralysis: 80% of eligible paralysis  patients presenting to the emergency department should be treated with tPA clot dissolving drug within 60 minutes.
Door to antibiotic time in community acquired pneumonia is the time to start antibiotics. Practice guidelines suggest that all patients hospitalised with community-acquired pneumonia should receive antibiotics within 4 h of admission
Door to antibiotic time in meningitis of more than 6 hour is linked to high mortality (8.64 times).
Door to needle time in acute heart attack is the time before which the clot dissolving drug should be given:  In ST elevation heart attack recommended that the door-to-needle time should be less than 30 minutes.
Door to balloon time is for angioplasty. Primary percutaneous coronary intervention  is now preferred for most patients if it can be performed by an experienced operator with less than a 90 minute delay from presentation to the emergency department.


Dr Deepak Chopra on Quantam Mechanics

Poetic interlude "We come spinning out of nothingness scattering stars like dust" –Rumi
Schrodinger’s equation explains every atom in the periodic table of elements & its appearance from nothingness
Schrodinger’s equation is a mathematical formulation that accounts for the appearance of all atoms in the universe from nothingness
Schrodinger’s wave function equation describes the distribution map for a particle appearing in & out of existence from nothingness
Subatomic particles appear from the nothingness of space, exist, & disappear into the nothingness at lightening speed
Subatomic particles can travel along many paths simultaneously
Subatomic particles can be in more than one place at the same time
Subatomic particles can disappear & reappear in another location without existing in the intervening space
Waves of potentiality are trans–empirical, unobservable, but real as without them particles would not exist
Waves of potentiality, unlike particles, do not have physical units of mass or energy. They are numbers or ratios of numbers
When particles are left alone or not interfered with they spontaneously evolve into waves of potentiality
As particles quantum objects are material & in the empirical world (verified by observation/measurable) As
waves they are not material
Quantum objects exist as particles/waves. As particles they have physical properties of mass & energy.As waves they are possibilities

Monday, May 30, 2011

World No Tobacco Day: Rahul Dev Message in Hindi

video

Rahul Dev Audio Mesage on No Tobacco Day

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Rahul Dev On World No Tobacco Day

Cine Star Rahul Dev Released a health message on the eve of World No Tobacco Day " Smoking can cause erectile dysfunction in men and premature ageing in women.Along with him on the photo Dr KK Aggarwal Padmashri Awardee.

Rahul Dev Releases Anti Tobacco Messages



Rahul Dev Cine Star in a function organised by Heart Care Foundation of India released anti tobacco messages. Mr Dev requested all to avoid passive smoking. Along with him Dr K K Aggarwal.

Safety of on-duty doctors


Jail inmates beat doctor to death in Gopalganj: A doctor, Bhudev Singh, died in Patna Medical College, hours after he was beaten up by some inmates of a district jail in Gopalganj district of Bihar on Sunday.
The crashed air ambulance carrying the patient violated air norms:  The air ambulance that crashed in Faridabad killing 10 people including two medical residents and one male nurse last Wednesday seriously violated the government's air safety rules and regulations that ban medical evacuation in single-engine aircraft. The aircraft was carrying a patient from Patna who had slipped into coma.  “Operations with single-engine aeroplanes shall be conducted only on domestic sectors except for medical evacuation flights,” the relevant clause of the CAR clearly says. Single-engine aircraft cannot handle sudden emergencies.
These two headlines in the newspaper open up a new debate regarding the safety of practicing doctors. Both incidents occurred while on duty. It’s time for the medical associations in India to fight for the safety of the on-duty doctors.
Treating doctors are uninformed and give consent to travel in whatever arrangements are made for them. They are made to travel in ill-equipped ambulances, ill-fitted aircrafts, and in vehicles who rush their travel violating all traffic rules. The travel is often unsafe from all standards. We must raise our voice and fight for our rights.
I met one of the journalists who told me the sequence of events. One of the jail inmates, who happens to be a politician in Bihar, wanted a doctor to sign a false certificate declaring that the jail inmate was sick and was unfit to be transferred to another jail. When the doctor denied on merit that he would not give a false certificate, he was beaten up by the politician and his accomplices and the doctor ultimately died.
Is it what the doctors have to pay today for being truthful? I think a nationwide protest should be held and such politicians should be punished.
I reproduce below an email that I received today from a colleague, regarding this incident.

“Dear Dr Aggarwal, I was shocked to hear the morning new on TV today – “Doctor who was sent to examine the inmates in Bihar jail was beaten to death by inmates.” The reason – he refused to issue a false medical certificate. I am sure lots of hue and cry will be raised by the media, public and also the medical associations. No one will reach the bottom of such incidents. The basic reason behind all these incidents is dereliction of duty by someone who is in-charge.

Will the Jail Superintendent accept the responsibility for not providing security to the doctors?
Will someone tell me if an armed constable was posted to regulate the entry of patients (inmates) in the dispensary?

Will the CMO and Director of Health explain and accept the responsibility for sending the doctor to such place which was a high security risk without verifying the facilities and security for him?
 This is pure apathy of the administration and it is this culture that is responsible for all the incidents of manhandling of doctors everywhere. All the above individuals need to explain and those who are responsible should be dismissed from service and cases filed against them for dereliction of duty. Dr RS Bajaj, Consultant Pediatrician, Rohini.”

96 km walk if you want to go to Mansarovar

From this year the walking track will cover 96 km ( 76 km lat year) if you are planning to go to Mansarovar yatra.  Only fir person can think of going there. The travel involves walking and climbing to high altitude. For those who can not adopt to this much exertion should think of taking Amar nath ki yatra of Yamonitri-gangotri- kedarnath- Badrinath yatra. You do not drive your car to a long distance without a servicing of the car the same is true for the human body. Get it cjceked up and if fit only than plan a travel to mansarover.

Are doctors safe during their practice

1.       Jail inmates beat doctor to death in Gopalganj: A doctor, Bhudev Singh, died in Patna Medicaol College hours after he was beaten up by some inmates of a district jail in Gopalganj district of Bihar on Sunday.
2.        The crashed air ambulance carrying the patient violated air norms:  The air ambulance that crashed in Faridabad killing 10 people including two medical residents and one male nurse last Wednesday seriously violated the government's air safety rules and regulations that ban medical evacuation in single-engine aircraft. The aircraft was carrying a patient from Patna who had slipped into coma.  “Operations with single-engine aeroplanes shall be conducted only on domestic sectors except for medical evacuation flights,” the relevant clause of the CAR clearly says. Single-engine aircraft cannot handle sudden emergencies.

These two newspaper headlines open a new debate regarding the medical safety of practicing doctors. Both incidents occurred while on duty.  It’s time for the medical association in India to fight for the safety of the on duty doctors.
 Treating doctors are ignorant and give consent to travel in whatever arrangements are made for them. They are made to travel in ill equipped ambulances, ill fitted air craft, and in vehicles who rush their travel violating all traffic rules. The travel is often unsafe from all standards. We must raise our voice and fight for our rights.
Lets debate and show our protest


zSHARE - Dr K K Agarwal on Aum Chanting.MP3

zSHARE - Dr K K Agarwal on Aum Chanting.MP3

zSHARE - Dr K K Aggarwal on what food combinations one should avoid.MP3

zSHARE - Dr K K Aggarwal on what food combinations one should avoid.MP3

Sunday, May 29, 2011

Smoking can cause Erectile Dysfunction


One reason for a man or a woman not to smoke is that a man is likely to end up with erectile dysfunction and the woman with premature aging with wrinkles on face, said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India.

It has been shown that men who smoke more than 20 cigarettes a day have 60% higher risk of erectile dysfunction as compared to those who never smoke. Fifteen percent of past and present smokers experience erectile dysfunction. Men, who are current smokers or are former smokers, are 30% more likely to suffer from erectile dysfunction. Among men who never smoke, only 12% end up with erectile dysfunction.
Smoking increases the risk of erectile dysfunction by more than 50% in men in the 30–40 year age group. Diabetes, high blood pressure and high cholesterol are other important risk factors for erectile dysfunction.
Apart from erectile dysfunction, smoking also causes reduced volume of ejaculation, low sperm count, sperm shape etc.

In women, smoking leads to premature aging with formation of wrinkles on the face.
@DrKKAggarwal Twitter
Krishanh Kumar Aggarwal Facebook
http://www.blogs.kkaggarwal.comn/

NIH stops clinical trial on combination cholesterol treatment

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health has stopped a clinical trial studying a blood lipid treatment 18 months earlier than planned. The trial found that adding high dose, extended–release niacin to statin treatment in people with heart and vascular disease, did not reduce the risk of cardiovascular events, including heart attacks and stroke.

Participants were selected for AIM–HIGH because they were at risk for cardiovascular events despite well–controlled low–density lipoprotein (LDL or bad cholesterol). Their increased risk was due to a history of cardiovascular disease and a combination of low high–density lipoprotein (HDL or good cholesterol) and high triglycerides, another form of fat in the blood. Low HDL and elevated triglycerides are associated with an increased risk of cardiovascular events. While lowering LDL decreases the risk of cardiovascular events, it has not been shown that raising HDL similarly reduces the risk of cardiovascular events. During the study’s 32 months of follow–up, participants who took high dose, extended–release niacin and statin treatment had increased HDL cholesterol and lowered triglyceride levels compared to participants who took a statin alone. However, the combination treatment did not reduce fatal or non–fatal heart attacks, strokes, hospitalizations for acute coronary syndrome, or revascularization procedures to improve blood flow in the arteries of the heart and brain.

The AIM–HIGH trial, which stands for Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health, enrolled 3,414 participants in the United States and Canada with a history of cardiovascular disease who were taking a statin drug to keep their LDL cholesterol low. Study participants also had low HDL cholesterol and high triglycerides, which meant that they were at significant risk of experiencing future cardiovascular events. Niacin, also known as Vitamin B3, has long been known to raise HDL and lower triglycerides. Eligible participants were randomly assigned to either high dose, extended–release niacin (Niaspan) in gradually increasing doses up to 2,000 mg per day (1,718 people) or a placebo treatment (1,696 people). All participants were prescribed simvastatin (Zocor), and 515 participants were given a second LDL cholesterol–lowering drug, ezetimibe (Zetia), in order to maintain LDL cholesterol levels at the target range between 40–80 mg/dL.
Researchers began recruiting participants in early 2006. The study was scheduled to finish in 2012. The average age of the participants was 64 years. Pre-existing medical conditions included coronary artery disease (92 percent); metabolic syndrome, which is a cluster of risk factors for heart disease (81 percent); high blood pressure (71 percent); and diabetes (34 percent). More than half of participants reported having a heart attack prior to entering the study.

The rationale for the AIM–HIGH study was based in part on a large number of observational studies that consistently showed that low HDL cholesterol increases the risk of cardiovascular events in men and women, independent of high LDL cholesterol. In addition, previous small clinical studies showed that relatively high residual cardiovascular risk exists among patients with cardiovascular disease, low HDL cholesterol, and high triglycerides despite intensive management of LDL cholesterol.

zSHARE - Dr K K Aggarwal on why no curd is eaten in dinner.MP3

zSHARE - Dr K K Aggarwal on why no curd is eaten in dinner.MP3

Making the Kailash–Mansarovar Yatra safe


Preventing mountain sickness

1. An altitude over 3,000 meters (9,843 feet) is usually defined as high altitude.
2. Acute mountain sickness (AMS) depends on the elevation, the rate of ascent and individual susceptibility.
3. Most visitors suffer from some symptoms that will generally disappear through acclimatization in several hours to several days.
4. Symptoms are worse at night and include headache, dizziness, lethargy, loss of appetite, nausea, breathlessness and irritability. Difficulty sleeping is another common symptom, and many travelers have trouble sleeping for the first few days.
5. AMS can be very serious, with the most serious symptoms being High Altitude Pulmonary Edema (HAPE) and High Altitude Cerebral Edema (HACE), which can be fatal. Symptoms of HAPE include weakness, shortness of breath, even at rest, impending suffocation at night, and a persistent productive cough with white, watery, or frothy fluid. Symptoms of HPCE may include headache, ataxia, weakness, hallucinations, psychotic behavior, coma and loss of memory. Both approach and strike at night and can be fatal! Immediate descent is the surest treatment.
6. A gradual ascent allows the body to acclimatize to higher altitudes and the decreased oxygen supply.
The formula is to give a night halt between 7000 to 10,000 feet; night halt for every 1500 feet climb and full day halt for every 3000 feet climb thereafter.
7. Medication also helps to prevent AMS.
8. One should avoid exercise in the first few days. Attempt to do only half of your activities on the first day while your body is working to acclimatize to higher altitude oxygen conditions.
9. No alcohol in the first few days.
10. No smoking.
11. Drink enough water each day so that your urine runs clear.
12. Make sure you get enough calories. Low cal diets at high altitudes can sabotage health. A well nourished body can adjust to changes better than an undernourished one can. One should take high carb diet.
13. One should avoid taking tranquilizers and sleeping pills. These will depress the respiratory drive and limit oxygen intake.
14. Prophylactic drugs are acetazolamide, nifedipine etc.

Doctors should quit smoking

Summary:
Doctors are role model for the society and should not smoke at all and particularly in public. It is also true that even doctors find it hard to quit smoking. The answer therefore is not to start smoking or quitting it as early as possible before it becomes a hard hitting habit, said Padma Shri and Dr. B.C. Roy National Awardee. Dr. KK Aggarwal, President Heart Care Foundation of India.
Text
Even doctors find it hard to quit smoking. Therefore, in the first place, the answer is not to start smoking or quitting as early as possible before it becomes a hard hitting habit.
Doctors are a role model for the society and should not smoke at all and even if they do, it should not be before patients or at social gatherings. A doctor cannot advise quitting smoking if he/she himself/herself smokes.
Most doctors start smoking before they enter medical colleges and continue to do so because of the hardships one goes through during the medical college education. For quitting smoking, these doctors can set an example in the society. It is easier for doctors to quit smoking than patients or general public as counseling a doctor is much easier than a non–doctor. However, doctors cannot counsel themselves and therefore, they need a counselor and help from another doctor.

Saturday, May 28, 2011

zSHARE - Dr K K Aggarwal on Satyuga.MP3

zSHARE - Dr K K Aggarwal on Satyuga.MP3

dr KK Says it is possible to be a satyugi even in kaliyuga. Listen and understand the concept.

zSHARE - Dr K K Aggarwal on understanding GOD in computer language.MP3

zSHARE - Dr K K Aggarwal on understanding GOD in computer language.MP3

Dr KK Says one can understnd GOD in computer terms. Listen and stay tuned.

Making the Kailash–Mansarovar Yatra safe


Known as the abode of Lord Shiva and his consort Goddess Parvati, Kailash Mansarovar is set in the remote mountains of western Tibet. The snow–clad Mt. Kailash is situated at an altitude of 22,228 ft (6,714 m) and is regarded as the world’s most sacred place. The pilgrimage is a 53 km-walk around the Kailash. It is the spiritual center for four great religions: Tibetan Buddhism, Hinduism, the Jain religion and the pre Buddhist animistic religion – Bonpo. The Mansarovar Lake is one of the holiest, captivating, stimulating, famous and the most ancient lake known to the civilization. It is the source of four great rivers: the Indus, the Sutlej, the Brahmaputra and the Karnali. The Kailash Mansarovar Yatra involves trekking at high altitudes up to 19,500 feet, under inhospitable conditions including extreme cold and rugged terrain and hence demands good health and physical fitness. The travel may prove hazardous for those who are not physically or medically fit.

People with problems of hypertension, diabetes, heart ailments, epilepsy and asthma should avoid this journey or consult their doctor before planning to undertake the Yatra.
One should start the physical fitness program several weeks before starting the journey. Walking, hiking and backpacking over rugged terrain are the best ways to prepare for a trek. Any regular regime of strenuous aerobic exercise is also beneficial as also running, swimming and cycling prior to departure.
Only citizens who are over 18 years old are allowed to travel.
The duration of the pilgrimage is 26 days.
Medical tests include: Hb, TLC, DLC, ESR, platelet count, blood sugar (F & PP), BLOOD urea, creatinine, serum bilurubin & SGOT–SGPT, blood group, lipid profile, urine R/E, chest X–ray, treadmill test, ECG, pulmonary function tests (Optional) and stress–echo–test (if recommended by doctor).
One should take appropriate quantities of the right medicines for a wide variety of ailments: Your personal medicines + antibiotics for stomach infection, chest infection etc, breathing/heart and BP related problems, diarrhea, vomiting and body–pain related oral medicines and topical ointments, anti allergic drugs.
Women’s hygiene products and medicines
Doctor’s certificate: Pulse rate, height, weight, respiratory rate, blood pressure, current ailment, past ailments, allergies if any, drugs on, prophylactic drugs list.

Friday, May 27, 2011

zSHARE - Benefits of smoking.MP3

zSHARE - Benefits of smoking.MP3

zSHARE - Cigar as bad as cigerette.MP3

zSHARE - Cigar as bad as cigerette.MP3

zSHARE - Smoking can cause erectile dysfunction.MP3

zSHARE - Smoking can cause erectile dysfunction.MP3

zSHARE - Doctors should quit smoking.MP3

zSHARE - Doctors should quit smoking.MP3

zSHARE - Tobacco is a drug.MP3

zSHARE - Tobacco is a drug.MP3

zSHARE - Smoking in pregnancy.MP3

zSHARE - Smoking in pregnancy.MP3

Cops detain IIT boy, extort money for 'porn' on phone

Piyush, after a long journey from his home in Chhattisgarh, got off at Dadar station only to be picked up by a group of railway policemen who snatched his phone and threatened to arrest him for allegedly having pornographic clips on it. They then extorted money out of him after intimidating him with handcuffs and belts inside a locked-up police chowky. This wasn't the first time the policemen had pulled a trick like this. The entire episode was perfectly set up. Such cases of extortion are common. Such policeman should be punished. Police has no powers to violate the privacy of a citizen without provocation. 

6 simple steps to keep your mind sharp at any age ( Harvard HealthBeat)

1. Keep learning: Challenging your brain with mental exercise is believed to activate processes that help maintain individual brain cells and stimulate communication among them.

2. Use all your senses: The more senses you use in learning something, the more of your brain will be involved in retaining the memory.

3. Believe in yourself: Middle–aged and older learners do worse on memory tasks when they’re exposed to negative stereotypes about aging and memory, and better when the messages are positive about memory preservation into old age.

4. Prioritize your brain use: Take advantage of calendars and planners, maps, shopping lists, file folders, and address books to keep routine information accessible. Designate a place at home for your glasses, purse, keys, and other items you use often.

5. Repeat what you want to know: When you want to remember something you’ve just heard, read, or thought about, repeat it out loud or write it down.

6. Space it out: Repetition is most potent as a learning tool when it’s properly timed. It’s best not to repeat something many times in a short period, as if you were cramming for an exam. Instead, re–study the essentials after increasingly longer periods of time — once an hour, then every few hours, then every day. Spacing out periods of study is particularly valuable when you are trying to master complicated information, such as the details of a new work assignment. 

zSHARE - akashwani Dr K K Aggarwal 01 6th april 2011- Track 1.mp3

zSHARE - akashwani Dr K K Aggarwal 01 6th april 2011- Track 1.mp3

Thursday, May 26, 2011

Air ambulance crashes near Delhi, 10 killed

Ten persons, including all seven onboard a small civil chartered aircraft were killed when the medical ambulance flight to Delhi  from Patna crashed into a densely-populated residential area in bad weather near Faridabad on Wednesday.
Faridabad's SDM Pradeep said three persons on ground were among the dead when the P-12 turboprop aircraft belonging to Delhi-based Air Chartered Services India Pvt Limted crashed in Jawaharnagar locality near the IAF station at around 1035 PM shortly before landing at IGI airport in Delhi.

Two persons were also injured in the crash. The persons who lost their lives on the ground are believed to be residents of the houses hit by the plane.
According to Delhi airport sources, the airplane lost control and nosedived from a height of about 8,000 feet fifteen minutes before landing. There was strong gusty winds due to a duststorm at the time of the crash.

The plane caught fire as soon as it crashed on two houses sending up plumes of smoke.

The airplane was ferrying a critically ill patient Rahul Raj, a young Patna-based businessman, to be taken to Apollo Hospital in New Delhi for further medical management. Raj, who was in coma, was undergoing treatment in Patna's Jagdish Memorial hospital. The airplane was arranged by Apollo Hospital.

Besides the two pilots, two doctors and two medical attendants accompanying the patient were on board the ill-fated aircraft. The plane was piloted by Harpreeet with Manjeet Kataria as the co-pilot.

Dr Arshad and Dr Rajesh were the doctors while Ratnesh Kumar and Shiril the medical attendants.

The bodies of all the 10 victims were charred beyond recognition, according to Faridabad Police Commissioner P K Agarwal.
TOI adds: A small aircraft with seven on board crashed into a colony in Faridabad's sector 22 around 10.45 pm on Wednesday, killing all on board. They included the 22-year-old patient, Rahul Raj, an attendant, two doctors, one male nurse, the pilot and co-pilot. Those killed were Dr Rajesh, Dr Arshad, Captain Harpreet, co-pilot Manpreet Kataria, Ratnesh Kumar and male nurse Cyril.
Padmashri Awardee Dr K K Aggarwal, editor emedinews comments: This is a typical professional hazard with both doctors and the patients loosing their life. There should be guidelines for the safety of doctors and the nurses who travel to carry patients.  

zSHARE - BK SAPANA Stress Management.mp3

zSHARE - BK SAPANA Stress Management.mp3

zSHARE - Dr K K Aggarwal Stress Management Session 1.mp3

zSHARE - Dr K K Aggarwal Stress Management Session 1.mp3

zSHARE - Strees Prevention Skills B K ASHA.mp3

zSHARE - Strees Prevention Skills B K ASHA.mp3

zSHARE - Dr K K Agarwal Stress Prevention Workshop Session 3.mp3

zSHARE - Dr K K Agarwal Stress Prevention Workshop Session 3.mp3

zSHARE - PRATICAL TIPS OF Strees Prevention B K Brij mohan.mp3

zSHARE - PRATICAL TIPS OF Strees Prevention B K Brij mohan.mp3

Wednesday, May 25, 2011

zSHARE - 07- RAKESH MEHETA- Stress Prevention.mp3

zSHARE - 07- RAKESH MEHETA- Stress Prevention.mp3

zSHARE - KK Aggarwal ki Allopathic Ramayana.MP3

zSHARE - KK Aggarwal ki Allopathic Ramayana.MP3

Revise your knowledge about Armpit Test

In the month of Jyestha, days are the longest in the year and the summer is at its peak. Hence, cases of heat cramp, heat exhaustion and heat stroke are expected. This trend will continue in the month of Ashadh with the rise in heat index, though the overall temperature of the environment may be low but the humidity will be high.

It is the heat index which decides occurrence of heat exhaustion and heat stroke. With high humidity, the heat index may be much higher in the presence of relatively low environmental temperature.

One should differentiate between heat cramps, heat exhaustion and heat stroke. In heat stroke, the internal temperature may be very high and may not respond to injectible or oral paracetamol. In such cases, the temperature of the body needs to be lowered over minutes and not hours. Clinically, both heat exhaustion and heat stoke may have fever, dehydration and alike symptoms. The main difference will be abnormal "arm pit test". Normally, axillae will always be wet even if a person is suffering from severe dehydration. If the axillae are dry and the person has high fever, it invariably means that he has gone from heat exhaustion to stroke and one should treat this as medical emergency.
Dr KK Aggarwal
Editor in Chief

Tuesday, May 24, 2011

Illegal abortion: Two–year jail for doctors

Recently, a court in Faridkot, Punjab sentenced two doctors to 2–year imprisonment for indulging in illegal abortion. In this case, both the doctors helped in the termination of a three–month fetus deeming it to be female fetus but after abortion, the fetus was found to be male. The wrong sex determination and its termination led to a lot of protest and uproar by the same family which went for abortion thinking the fetus was a female. The case happened in January 2007 when one of the doctors concluded from an ultrasound examination that the fetus was female and on the request of the family members, it was terminated by another doctor. The case opens a lot of questions:
1. Sex determination is still taking place in Punjab?
2. Termination of pregnancy is still being done if the fetus is female.
3. Ultrasound can often misdiagnose a male fetus as female; not seeing a male organ in the fetus does not mean that the fetus is female.
4. In such cases, the family which also consents for abortion invariably comes out free of blame and it is the doctor who faces the punishment.
5. Action should have been taken not only against the doctors but also against the parents who consented for the abortion.

Dr KK Aggarwal
Editor in Chief
Padmashri and Dr B C Roy National Awardee

PNDT Update

  1. Soon, sex selection may cost a doctor his licence to practice. As per new directions, Union Health Ministry through Medical Council of India is likely to direct all State Medical Councils to identify the doctors convicted till date under the PNDT Act and ensure that their licence to practice is cancelled permanently. So far about 800 court cases against doctors in 17 states have resulted in 55 convictions.
  2. A city court of Gurgaon in March convicted five Gurgaon doctors under PNDT Act and ordered rigorous imprisonment of three years with a fine of Rs. 1000 each. The doctors were Dr. J.L.M, Dr. M.S.T, Dr. D.B.L, Dr. P.B.L, and Dr. KSS. They have all been convicted for committing offence under section 23 of PNDT Act. The doctors were caught red-handed on the spot by a decoy team.
  3. A high level meeting convened by the Prime Minister’s Office looked into the possibility of making abortion a subject to checks like mandatory counseling and medical advice.
eMedinewS comments: When parents do not want a child, they have options of emergency contraception in the first 72 hours, medical pill abortion upto 8 weeks and surgical abortion upto 12 weeks. In all probabilities, if a decision to terminate the pregnancy is taken after 12 weeks, the parents somehow know the sex of the fetus. Will the Government consider banning an abortion after 12 weeks or making abortion after 12 week more stringent and more monitored? Will the law also consider taking action against the parents. Till now, many doctors have been convicted but not even a single parent has been punished for getting an abortion done.