Frequent travel can double one’s risk of blood clots

Frequent travel can double one’s risk of blood clots New Delhi, July 24, 2016: Long distance travelers periodically should move around and stretch their legs, and drink plenty of water to stay hydrated, saidPadma Shri Awardee Dr KK Aggarwal – President Heart Care Foundation of India (HCFI) and Honorary Secretary General IMA. Long–distance travel can lead to potentially fatal blood clots in some people –– showing that the risk grows with the length of the trip. Certain people are at increased risk of blood clots, including cancer patients, people who have recently had major surgery such as a joint replacement, and women on birth control pills. In general, travel is associated with a nearly three-fold increase in the risk of venous thromboembolism (blood clots that form in the veins), often in the legs. If such a clot dislodges and travels to the lungs, it can cause a potentially fatal condition called pulmonary embolism. A combination of factors including dehydration and hours of sitting in cramped conditions explains why some people develop blood clots. A review, published in the Annals of Internal Medicine, analyzed 14 studies involving more than 4,000 cases of venous thromboembolism and found that travelers had a nearly three–fold higher risk of blood clots than non–travelers. The risk climbed along with the duration of the trip –– rising 18 percent for every two hours of any type of travel, and by 26 percent for every two hours of air travel. But there is no reason for panic, because the absolute risk to any one traveler is still low. People who travel long distances should be aware of the risk of blood clots and learn to recognize the symptoms. Symptoms of a blood clot in the leg include pain, warmth, swelling and redness in the limb. If the clot travels to the lungs, it may cause sudden shortness of breath, chest pain or a cough that produces blood.

Strong evidence that alcohol causes cancer at seven sites in the body

Strong evidence that alcohol causes cancer at seven sites in the body

Dr K K Aggarwal There is strong epidemiological evidence that alcohol causes cancer at seven sites in the body and probably others, says a new study in the latest issue of the journal Addiction reported 21st July, 2016. These sites include oropharynx, larynx, esophagus, liver, colon, rectum and female breast. A "dose-response relationship" between alcohol and cancer was observed for all these cancers, where the increase in cancer risk with increased average consumption is monotonic, either linear or exponential, without evidence of threshold of effect. The beverage type did not appear to influence any variation. The strength of the association with alcohol varies by site of the cancer, being particularly strong for mouth, pharynx and esophagus (relative risk in the range of 4–7 for ≥ 50 g of alcohol per day compared with no drinking) and less so for colorectal cancer, liver and breast cancer (relative risk approximately 1.5 for ≥ 50 g/day). Alcohol-attributable cancers at these sites were estimated to make up 5.8% of all cancer deaths globally. These conclusions are based on comprehensive reviews undertaken in the last decade by the World Cancer Research Fund and American Institute for Cancer Research, the International Agency for Research on Cancer, the Global Burden of Disease Alcohol Group including a comprehensive dose–response meta-analysis published last year in the British Journal of cancer. In the study, Jennie Connor, Dept. of Preventive and Social Medicine, University of Otago, New Zealand from New Zealand attempted to clarify the strength of the evidence for alcohol as a cause of cancer, and the meaning of cause in this context. Even without complete knowledge of biological mechanisms, the authors observed, the epidemiological evidence can support the judgment that alcohol causes cancer of these seven sites.

B12 deficiency can be the underlying cause of short term memory loss

B12 deficiency can be the underlying cause of short term memory loss New Delhi, July 3, 2016: If you are forgetting things often, it is recommended that you get your vitamin B 12 levels checked instead of worrying that you may be suffering dementia, said Padma Shri Awardee Dr KK Aggarwal - President Heart Care Foundation of India and Honorary Secretary General IMA. Animal products (meat and dairy) are the only dietary source of B12 (cobalamin - Cbl) for humans. Strict vegans who do not consume any animal products are at a high risk of developing nutritional Cbl deficiency. The usual western diet contains 5 to 7 micrograms of cobalamin per day, while the minimum daily requirement is 6 to 9 micrograms per day. Total body stores of Cbl are 2 to 5 mg and one-half of this is in the liver. It takes years to develop vitamin B12 deficiency after absorption of dietary B12 ceases. There is a link between infection with Helicobacter pylori (as seen in peptic ulcer) and low serum B12 levels. Mild and usually subclinical cobalamin deficiency can also occur in 24% of the elderly. People taking metformin, those who are obese, suffer from diabetes or polycystic ovarian disease are at a higher risk of suffering from Vitamin B12 deficiency. This can however, be reversed with oral calcium supplementation. Prolonged use of omeprazole (given for acidity) can result in Cbl deficiency. Women who are only moderate vegetarians may become Cbl deficient during pregnancy and lactation. Their infants also run the risk of being Cbl deficient.

Good students can keep the teacher more informative and up-to-date in the subject - Dr Rohit V Bhatt, Emeritus Professor of Obstetrics and Gynecology at Medical College, Baroda.

Good students can keep the teacher more informative and up-to-date in the subject - Dr Rohit V Bhatt, Emeritus Professor of Obstetrics and Gynecology at Medical College, Baroda. Dr KK Aggarwal, Editor in Chief eMedinewS and IMA News in conversation with Dr Rohit V Bhatt, Emeritus Professor of Obstetrics and Gynecology at Medical College, Baroda. Dr Rohit V Bhatt has been honored with Dr BC Roy National Award for the year 2008 under the category of ‘Eminent Medical Teacher’. How does it feel being conferred one of the most prestigious awards in the medical field? I feel happy and honored to receive the prestigious BC Roy Award. I am also happy that my merit is recognized. It gives impetus to do better in teaching. Teaching keeps you on guard about latest updates in your specialty. All teachers should have love for teaching and their students. A good teacher should also remain a lifelong student to learn and innovate new ideas. Recognition of merit acts as a great stimulant to do better. Tell us about your journey so far. I started my teaching career in Ahmadabad and then shifted to Medical College, Baroda till my retirement. I come from a family of teachers and though less lucrative, I made teaching my life mission. I feel balance of gratitude from students and colleagues is more satisfying and rewarding than balance in the bank. I had the privilege to be the president of Federation of Obst Gyne Societies of India (FOGSI), National Association of Reproductive and Child health (NARCHI) and Indian Society of Perinatology and Reproductive Biology (ISOPARB). I was the chairperson of Indian College of Obstetrics and Gynecology (ICOG) and Indian college of Maternal and Child health (ICMCH). I have also been vice-president of Asia Oceania Federation of Obstetricians and Gynecologists (AOFOG) and held the post of chairman of ‘Maternal Health Committee of FOGSI and AOFOG. I had the pleasure to be a consultant to WHO, The Population Council and Population Services International. I was director for Training doctors in Laparoscopy for John Hopkins Program International in gynec and obstetrics (JHPIGO). I have delivered several orations in India and overseas. My love for teaching continued even after my retirement and I visit my dept. to teach postgraduates. What were the early challenges faced by you in your career? How did you manage to overcome them? I joined as full time teacher in the medical college and was the first full-time teacher. Others were visiting honorary teachers. After initial phase of conflicts, I could establish myself as a good teacher, administrator and supportive to my students. I realized that confrontation does not help. What is required is the spirit of goodwill and cooperative frame of mind… I succeeded in establishing harmonious relations with honorary staff. The teachers had more interest in patient care and less on teaching. I succeeded in establishing an academic atmosphere amongst the students and teachers by holding journal club meetings, periodic department meeting about teaching evaluation and guidance to students. The students talked about their dissertation and got sound advice from staff members. I involved the postgraduates and residents in clinical research. I find they perform better when they are involved in research. Tell us about your family. How important has been the role of your family in your journey? I come from family of teachers, lawyers and judges. I was the first doctor in my family. My parents had a great influence on my academic career. My father quoted William Osler’s comment on a good teacher. The comment says, “A good teacher must be physically exhausted but mentally exhilarated at the end of the day.” I have tried to follow Osler’s saying. I was the youngest in my family and received great support from my brothers and sister. After my marriage, my wife played a vital role in my career. She looked after home management and I concentrated on academics. She tolerated my absence when I took extra classes for my students or travelled out of station to deliver guest lecture or oration. I attribute my academic success to my wife’s sacrifices. My only son is very considerate and he too accepted my absence from home. He also followed my footsteps and has preferred to be a teacher What would be your message to the community? I feel the relation between doctors and the community are not very healthy. Doctor- patient relationship should be cordial. There may be some fault on either side. The number of litigations is on the increase. Lure for money and pressure of work has affected healthy doctor-patient relationship. Patient and the relatives also need to understand the disease process and it is not always the fault of the doctor. I feel there is a need for more dialogue between doctors and the community to restore good will and confidence. Doctors should involve the patient and the relatives in decision making process and must explain about the disease process. The medical curriculum should cover communication skills and doctor-patient relationship Given a chance, what changes would you like to bring about in health policies? The present curriculum is too didactic and less practical. Increasing number of students in the colleges have diluted practical teaching. There should be more bedside teaching and should encourage student participation. Didactic lectures should be reduced. In many teaching hospitals, there is not enough material for clinical teaching Teacher-student ratio is not appropriate. Most teachers are devoted to work. But unfortunately, there are some teachers who hardly teach. There should be a mechanism to monitor teaching programs. The teachers must spend more time for the students. The medical curriculum should include exposure to behavioral science and human relations. What advice would you give to youngsters? Though money and a decent life is the wish of all, I would suggest that one can also lead a decent life with modest means. Students must develop love for the subject and keep eyes open to learn the nuances in medicine. Good students can keep the teacher more informative and up-to-date in the subject. The students need to be taught what good doctor-patient relationship is. They must be taught how to avoid confrontation with the patients and their relatives.